Shock complicating severe falciparum malaria in European adults
Identifieur interne : 002915 ( Main/Exploration ); précédent : 002914; suivant : 002916Shock complicating severe falciparum malaria in European adults
Auteurs : F. Bruneel ; B. Gachot ; J. F. Timsit ; M. Wolff ; J. P. Bédos ; B. Régnier ; F. VachonSource :
- Intensive Care Medicine [ 0342-4642 ] ; 1997-06-01.
English descriptors
Abstract
Abstract: Objective: To study adult patients with severe falciparum malaria who developed shock. Design: Retrospective study from 1987 to 1993. Setting: Medical intensive care unit in a university hospital. Patients: 14 patients admitted with severe falciparum malaria who developed shock. All received intravenous quinine. Measurements and results: The mean Simplified Acute Physiology Score II was 59.5 ± 7.1; 2.6 ± 0.4 criteria defining severe disease were present on admission in 12 patients; and initial parasitemia was 21 ± 6 %. Twelve patients received inotropic drugs. Pulmonary artery catheterization showed the following results in 7 patients: mean arterial pressure 57 ± 4 mmHg; pulmonary artery occlusion pressure 11 ± 1 mmHg; cardiac index 5.5 ± 0.9 l · min−1· m−2; and systemic vascular resistance index 783 ± 122 dyne · s · cm−5· m−2. Seven patients had evidence of bacterial infection at the time of shock. Of the 7 deaths (50 %), 5 were due to shock, with documented bacterial infection in all patients and persistent parasitemia in 4. Conclusions: Shock complicating severe falciparum malaria in adults is associated with peripheral vasodilation and carries a poor prognosis. In falciparum malaria with shock, bacterial coinfection should be suspected immediately and treated empirically with broad-spectrum antibiotics. Nevertheless, Plasmodium falciparum may contribute directly or indirectly to the onset of shock.
Url:
DOI: 10.1007/s001340050396
Affiliations:
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Vachon</name><affiliation><wicri:noCountry code="subField">FR</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="ISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="1997-06-01">1997-06-01</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="698">698</biblScope><biblScope unit="page" to="701">701</biblScope></imprint><idno type="ISSN">0342-4642</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0342-4642</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bacteremia</term><term>Cerebral malaria</term><term>Key wordsPlasmodium falciparum</term><term>Malaria</term><term>Pneumonia</term><term>Shock</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Objective: To study adult patients with severe falciparum malaria who developed shock. Design: Retrospective study from 1987 to 1993. Setting: Medical intensive care unit in a university hospital. Patients: 14 patients admitted with severe falciparum malaria who developed shock. All received intravenous quinine. Measurements and results: The mean Simplified Acute Physiology Score II was 59.5 ± 7.1; 2.6 ± 0.4 criteria defining severe disease were present on admission in 12 patients; and initial parasitemia was 21 ± 6 %. Twelve patients received inotropic drugs. Pulmonary artery catheterization showed the following results in 7 patients: mean arterial pressure 57 ± 4 mmHg; pulmonary artery occlusion pressure 11 ± 1 mmHg; cardiac index 5.5 ± 0.9 l · min−1· m−2; and systemic vascular resistance index 783 ± 122 dyne · s · cm−5· m−2. Seven patients had evidence of bacterial infection at the time of shock. Of the 7 deaths (50 %), 5 were due to shock, with documented bacterial infection in all patients and persistent parasitemia in 4. Conclusions: Shock complicating severe falciparum malaria in adults is associated with peripheral vasodilation and carries a poor prognosis. In falciparum malaria with shock, bacterial coinfection should be suspected immediately and treated empirically with broad-spectrum antibiotics. Nevertheless, Plasmodium falciparum may contribute directly or indirectly to the onset of shock.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Bedos, J P" sort="Bedos, J P" uniqKey="Bedos J" first="J. P." last="Bédos">J. P. Bédos</name><name sortKey="Bruneel, F" sort="Bruneel, F" uniqKey="Bruneel F" first="F." last="Bruneel">F. Bruneel</name><name sortKey="Gachot, B" sort="Gachot, B" uniqKey="Gachot B" first="B." last="Gachot">B. Gachot</name><name sortKey="Regnier, B" sort="Regnier, B" uniqKey="Regnier B" first="B." last="Régnier">B. Régnier</name><name sortKey="Timsit, J F" sort="Timsit, J F" uniqKey="Timsit J" first="J. F." last="Timsit">J. F. Timsit</name><name sortKey="Vachon, F" sort="Vachon, F" uniqKey="Vachon F" first="F." last="Vachon">F. Vachon</name><name sortKey="Wolff, M" sort="Wolff, M" uniqKey="Wolff M" first="M." last="Wolff">M. Wolff</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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