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Treatment in U.S. Is Rare Chance to Study Ebola
By DENISE GRADYAUG. 17, 2014
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Dr. Ribner said the key to treating Ebola patients was supportive care ? things like stabilizing blood pressure and pulse, maintaining the body?s balance of fluids and salts, and giving transfusions if needed. He said the idea was to keep patients alive long enough to allow their own immune systems to kick in and fight off the virus, which begins to happen two or three weeks into the illness.
Before the body can defend itself, the virus attacks blood vessels and internal organs, Dr. Ribner said. The damage to vessels can lead to the bleeding for which the disease is notorious, though it occurs in only about half of patients and is not as profuse as is sometimes reported. The infection also touches off inflammation that can harm the patient. But much of this damage seems to be reversible, Dr. Ribner said.
One of the most dangerous symptoms is severe diarrhea, comparable to what occurs in cholera, Dr. Ribner said. The result is an enormous loss of fluids and electrolytes like potassium and magnesium, which can shut down the kidneys and play havoc with heart rhythm. How the virus causes such diarrhea is not understood, he said.
?Patients lose a lot of potassium,? he said. ?I don?t think our colleagues realize how much.?
Doctors in Africa may not be aware of the severity of the electrolyte loss, he said, because hospitals there do not have the equipment to measure it. But he said that if doctors could be informed, they might be able to modify treatments to cope with the problem, even without the ability to monitor it.
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http://www.nytimes.com/2014/08/18/health/treatment-in-us-is-rare-chance-to-study-ebola.html?_r=0
By DENISE GRADYAUG. 17, 2014
...
Dr. Ribner said the key to treating Ebola patients was supportive care ? things like stabilizing blood pressure and pulse, maintaining the body?s balance of fluids and salts, and giving transfusions if needed. He said the idea was to keep patients alive long enough to allow their own immune systems to kick in and fight off the virus, which begins to happen two or three weeks into the illness.
Before the body can defend itself, the virus attacks blood vessels and internal organs, Dr. Ribner said. The damage to vessels can lead to the bleeding for which the disease is notorious, though it occurs in only about half of patients and is not as profuse as is sometimes reported. The infection also touches off inflammation that can harm the patient. But much of this damage seems to be reversible, Dr. Ribner said.
One of the most dangerous symptoms is severe diarrhea, comparable to what occurs in cholera, Dr. Ribner said. The result is an enormous loss of fluids and electrolytes like potassium and magnesium, which can shut down the kidneys and play havoc with heart rhythm. How the virus causes such diarrhea is not understood, he said.
?Patients lose a lot of potassium,? he said. ?I don?t think our colleagues realize how much.?
Doctors in Africa may not be aware of the severity of the electrolyte loss, he said, because hospitals there do not have the equipment to measure it. But he said that if doctors could be informed, they might be able to modify treatments to cope with the problem, even without the ability to monitor it.
...
http://www.nytimes.com/2014/08/18/health/treatment-in-us-is-rare-chance-to-study-ebola.html?_r=0