Ebola virus disease: the UK critical care perspective

D Martin; J Howard; B Agarwal; Y Rajalingam; B Athan; S Bhagani; I Cropley; S Hopkins; S Mepham; A Rodger; S Warren; M Jacobs

doi:10.1093/bja/aew098

Ebola virus disease: the UK critical care perspective

Br J Anaesth. 2016 May;116(5):590-6. doi: 10.1093/bja/aew098.

Authors

D Martin¹, J Howard², B Agarwal², Y Rajalingam², B Athan³, S Bhagani³, I Cropley³, S Hopkins³, S Mepham³, A Rodger⁴, S Warren³, M Jacobs³

Affiliations

¹ Critical Care Unit Division of Surgery and Interventional Science, University College London University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, London W1 T 7HA, UK [email protected].
² Critical Care Unit.
³ Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
⁴ Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK Research Department of Infection, University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK.

PMID: 27106962
DOI: 10.1093/bja/aew098

Abstract

The recent outbreak of Ebola virus disease (EVD) has required the treatment of affected patients in the NHS system within the UK. Managing patients with a confirmed viral haemorrhagic fever requires a thorough understanding of treatment options within the confines of an effective biocontainment setting. The Royal Free Hospital High Level Isolation Unit (HLIU) in London, is a purpose built facility that allows healthcare workers to safely treat patients with highly contagious diseases. This HLIU uses Trexler isolator tents to prevent the spread of infection from patients to healthcare workers. Provision of invasive organ support can be provided in this environment, if considered appropriate, and is achievable without posing additional risk to staff. We report our recent experiences of managing patients with EVD, with particular focus on those aspects of care pertinent to anaesthesia and critical care medicine.

Keywords: Anaesthesia; Ebola haemorrhagic fever; Ebola virus; critical care; multiple organ failure; viral haemorrhagic fever.

Publication types

Review

MeSH terms

Analgesia / methods
Conscious Sedation / methods
Critical Care / methods*
Health Personnel
Hemorrhagic Fever, Ebola / prevention & control*
Hemorrhagic Fever, Ebola / transmission
Humans
Infection Control / methods
Infectious Disease Transmission, Patient-to-Professional / prevention & control
Patient Isolation / methods
Patient Isolators
Respiration, Artificial / methods
United Kingdom