Malaria
Malaria
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DOI：
10.1007/978-3-030-33803-9_13
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发表时间：
2020-01-03
期刊：
影响因子：
--
通讯作者：
Concejo BA
中科院分区：
文献类型：
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作者：
Hidalgo J;Arriaga P;Concejo BA
疟疾是全世界发病和死亡的一个重要原因，未来几年环境变化可能会增加其重要性。诊断这种疾病很困难，需要高度怀疑，特别是在非流行国家。重症监护提供者在治疗严重疟疾及其并发症方面发挥着重要作用，其管理特殊性可能并不明显。应仔细调整液体复苏以避免并发症，与血容量不足相比，灌注不良似乎与寄生虫血症程度更相关。抗疟药物是有效的，但耐药性正在增加。几乎每个器官都可能出现并发症，包括脑型疟疾、急性呼吸窘迫综合征和急性肾损伤。因此，当器官出现时，经常需要重症监护病房来提供支持。叠加感染的情况并不少见。尽管如此，由于及时诊断和获得适当的治疗，死亡率仍然很低，令人鼓舞。
Malaria is a significant cause of morbidity and mortality throughout the world, and environmental changes are likely to increase its importance in the coming years. Diagnosing this disease is difficult and requires a high index of suspicion, especially in non-endemic countries. Critical care providers play a major role in treating severe malaria and its complications, which has management particularities that might not be readily apparent. Fluid resuscitation should be carefully tailored to avoid complications, and dysperfusion seems more related to degree of parasitemia than hypovolemia. Antimalarial agents are effective, but resistance is growing. Complications can be found in nearly every organ, including cerebral malaria, acute respiratory distress syndrome, and acute kidney injury. As such, a critical care unit is frequently required for organ support when they appear. Superimposed infections are not infrequent. Despite all of this, mortality is encouragingly low with a timely diagnosis and access to appropriate treatment.