Central venous catheters provide reliable vascular access in Ebola virus disease

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Abstract:

INTRODUCTION: Ebola Virus Disease (EVD) causes severe diarrhoea and vomiting, leading to dehydration and electrolyte abnormalities. Treatment remains supportive and often requires intravenous (IV) access. IV catheters are difficult to insert and maintain in this context. Our primary objective was to compare peripheral venous catheters (PVCs) and central venous catheters (CVCs) for volume resuscitation in patients with EVD.

MATERIAL AND METHODS: We performed a prospective observational study between January and March 2015 at the Conakry Healthcare Workers Ebola Treatment Unit (ETU). The primary judgement criterion was the ratio of the daily infused volume of fluids to the prescribed volume (DIV/PV).

RESULTS: Fourteen patients were admitted. Twenty-eight PVCs and 8 CVCs were inserted. CVCs had a longer survival time (96±34hours versus 33.5±21hours, P<0.001). The mean DIV/PV was higher for the CVCs (0.95±0.08 versus 0.7±0.27, P<0.001), as well as the number of days with full administration of prescribed IV fluids (71.2% versus 34.1%, P=0.002).

DISCUSSION: Inserting CVCs is a safe and reliable way of obtaining IV access in ETUs, provided adequately trained personnel are available. CVCs optimize fluid infusion compared to PVCs. Further studies comparing fluid management strategies in EVD are necessary.

Reference:

Cotte, J., Cordier, P.Y., Bordes, J., Janvier, F., Esnault, P., Kaiser, E. and Meaudre, E. (2015) Fluid resuscitation in Ebola Virus Disease: A comparison of peripheral and central venous accesses. Anaesthesia, Critical Care & Pain Medicine. November 2nd. [Epub ahead of print]

DOI: 10.1016/j.accpm.2015.06.010.

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