Management of severe malaria in the intensive care unit

Crit Care Clin. 2013 Oct;29(4):865-85. doi: 10.1016/j.ccc.2013.06.008. Epub 2013 Aug 15.

Abstract

Severe malaria is a medical emergency requiring early intervention to prevent death. This article highlights key aspects of the management of severe malaria syndromes in the intensive care unit, with a focus on individual case management of imported malaria. Key differences in the presentation, management, and outcomes of severe malaria by endemicity and by age group are emphasized. In all groups with severe malaria, intravenous artesunate is the antimalarial agent of choice. This article discusses specific antimalarial therapies, optimal supportive management strategies, differences from strategies for bacterial sepsis, and trials of adjunctive therapy for severe malaria in humans.

Keywords: Acidosis; Adjunctive therapy; Antimalarials; Fluid management; Respiratory failure; Sepsis; Severe malaria.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Antimalarials / therapeutic use*
  • Combined Modality Therapy
  • Fluid Therapy / methods
  • Humans
  • Intensive Care Units
  • Life Cycle Stages
  • Malaria, Falciparum* / complications
  • Malaria, Falciparum* / diagnosis
  • Malaria, Falciparum* / drug therapy
  • Plasmodium falciparum* / drug effects
  • Plasmodium falciparum* / physiology
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy
  • Sepsis / etiology*
  • Sepsis / prevention & control
  • Severity of Illness Index

Substances

  • Anti-Infective Agents
  • Antimalarials