Evidence-Based Guidelines for Supportive Care of Patients with Ebola Virus Disease

Authors

• François Lamontagne, Centre de recherche du CHUS de Sherbrooke
• Robert A. Fowler, Sunnybrook Health Sciences Centre
• Neill K. Adhikari, Sunnybrook Health Sciences Centre
• Srinivas Murthy, University of British Columbia
• David Brett-Major, University of Nebraska Medical CenterFollow
• Michael Jacobs, Royal Free London NHS Foundation Trust
• Timothy M. Uyeki, US Centers for Disease Control and Prevention
• Constanza Vallenas, World Health Organization
• Susan L. Norris, World Health Organization
• William A. Fischer, University of North Carolina at Chapel Hill
• Thomas E. Fletcher, Liverpool School of Tropical Medicine
• Adam C. Levine, International Medical Corps
• Paul Reed, Center for Global Health Engagement-Uniformed Services University of the Health Sciences
• Daniel G. Bausch, World Health Organization
• Sandy Gove, Integrated Management of Adolescent and Adult Illness-Integrated Management of Childhood Illness) Alliance
• Andrew Hall, London, UK
• Susan Shepherd, Alliance for International Medical Action
• Reed A. Siemieniuk, McMaster University
• Marie-Claude Lamah, Doctors Without Borders
• Rashida Kamara, Ministry of Health and Sanitation
• Phiona Nakyeyune, London School of Hygiene & Tropical Medicine
• Moses J. Soka, Ministry of Health
• Ama Edwin, Korle Bu Teaching Hospital
• Afeez A. Hazzan, McMaster University
• Shevin T. Jacob, University of Washington
• Mubarak Mustafa Elkarsany, Karary University
• Takuya Adachi, Toshima Hospital
• Lynda Benhadj, Université de Sherbrooke
• Christophe Clément, Polyclinique Bordeaux Nord Aquitaine
• Ian Crozier, Makerere University
• Armando Garcia, Doctors Without Borders
• Steven J. Hoffman, McMaster University
• Gordon H. Guyatt, McMaster University

Document Type

Article

Journal Title

Lancet

Publication Date

2018

Volume

391

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.

DOI Link

10.1016/S0140-6736(17)31795-6

ISSN

1474-547X

Rights

U.S. Government Work

Creative Commons License

This work is licensed under a Creative Commons Public Domain Dedication 1.0 License.

Recommended Citation

Lamontagne, François; Fowler, Robert A.; Adhikari, Neill K.; Murthy, Srinivas; Brett-Major, David; Jacobs, Michael; Uyeki, Timothy M.; Vallenas, Constanza; Norris, Susan L.; Fischer, William A.; Fletcher, Thomas E.; Levine, Adam C.; Reed, Paul; Bausch, Daniel G.; Gove, Sandy; Hall, Andrew; Shepherd, Susan; Siemieniuk, Reed A.; Lamah, Marie-Claude; Kamara, Rashida; Nakyeyune, Phiona; Soka, Moses J.; Edwin, Ama; Hazzan, Afeez A.; Jacob, Shevin T.; Elkarsany, Mubarak Mustafa; Adachi, Takuya; Benhadj, Lynda; Clément, Christophe; Crozier, Ian; Garcia, Armando; Hoffman, Steven J.; and Guyatt, Gordon H., "Evidence-Based Guidelines for Supportive Care of Patients with Ebola Virus Disease" (2018). Journal Articles: Epidemiology. 37.
https://digitalcommons.unmc.edu/coph_epidem_articles/37