Articles: malaria-complications.
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Critical care medicine · Aug 2004
Clinical TrialUnidentified acids of strong prognostic significance in severe malaria.
To calculate, using the Stewart approach to acid-base disorders, the strong anion gap as an estimate for the contribution of unmeasured plasma anions other than lactate to the metabolic acidosis that characterizes severe falciparum malaria and to assess its relative prognostic significance. ⋯ In severe malaria, unidentified anions other than lactate are the most important contributors to metabolic acidosis, a major cause of death. The strong anion gap is a powerful prognostic indicator in patients with severe malaria.
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Case Reports
Severe acute respiratory distress syndrome in a child with malaria: favorable response to prone positioning.
We present the case of a 4-year-old boy with malaria who developed acute respiratory distress syndrome with severe hypoxemia refractory to mechanical ventilation and inhaled nitric oxide. Placing the patient in prone position immediately and persistently improved oxygenation: the ratio of P(aO(2)) to fraction of inspired oxygen rose from 47 to 180 mm Hg and the oxygenation index decreased from 40 to 11. The patient survived, with no respiratory sequelae.
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Trop. Med. Int. Health · Feb 2004
Post-injury malaria: a risk factor for wound infection and protracted recovery.
To assess the impact of post-injury falciparum malaria on morbidity parameters in Cambodia. ⋯ Symptomatic malaria after trauma is common in Cambodia. Post-injury malaria seems to increase the risk of wound infection, delays postoperative recovery, and thus adds to the burden of trauma.
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Acidosis is now recognized as an important component of the severe malaria syndrome and a predictor of fatal outcome. Alterations in plasma potassium concentrations are commonly associated with acidosis. To date, there is little information about the changes in potassium in severe malaria. ⋯ Hypokalemia is a common complication of severe malaria; however, it is often not apparent on admission. On correction of acidosis, plasma potassium decreases precipitously, and thus careful, serial monitoring of serum potassium is suggested in patients with severe malaria complicated by acidosis.