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Evidence-based guidelines for supportive care of patients with Ebola virus disease.

Evidence-based guidelines for supportive care of patients with Ebola virus disease.
Author Information (click to view)

Lamontagne F, Fowler RA, Adhikari NK, Murthy S, Brett-Major DM, Jacobs M, Uyeki TM, Vallenas C, Norris SL, Fischer WA, Fletcher TE, Levine AC, Reed P, Bausch DG, Gove S, Hall A, Shepherd S, Siemieniuk RA, Lamah MC, Kamara R, Nakyeyune P, Soka MJ, Edwin A, Hazzan AA, Jacob ST, Elkarsany MM, Adachi T, Benhadj L, Clément C, Crozier I, Garcia A, Hoffman SJ, Guyatt GH,


Lamontagne F, Fowler RA, Adhikari NK, Murthy S, Brett-Major DM, Jacobs M, Uyeki TM, Vallenas C, Norris SL, Fischer WA, Fletcher TE, Levine AC, Reed P, Bausch DG, Gove S, Hall A, Shepherd S, Siemieniuk RA, Lamah MC, Kamara R, Nakyeyune P, Soka MJ, Edwin A, Hazzan AA, Jacob ST, Elkarsany MM, Adachi T, Benhadj L, Clément C, Crozier I, Garcia A, Hoffman SJ, Guyatt GH, (click to view)

Lamontagne F, Fowler RA, Adhikari NK, Murthy S, Brett-Major DM, Jacobs M, Uyeki TM, Vallenas C, Norris SL, Fischer WA, Fletcher TE, Levine AC, Reed P, Bausch DG, Gove S, Hall A, Shepherd S, Siemieniuk RA, Lamah MC, Kamara R, Nakyeyune P, Soka MJ, Edwin A, Hazzan AA, Jacob ST, Elkarsany MM, Adachi T, Benhadj L, Clément C, Crozier I, Garcia A, Hoffman SJ, Guyatt GH,

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Lancet (London, England) 2017 10 17() pii 10.1016/S0140-6736(17)31795-6

Abstract

The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients’ reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units. Key recommendations include administration of oral and, as necessary, intravenous hydration; systematic monitoring of vital signs and volume status; availability of key biochemical testing; adequate staffing ratios; and availability of analgesics, including opioids, for pain relief.

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