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Trop Med Int Health. 1998 Feb;3(2):156-61.

Exchange transfusion as an adjunct to the treatment of severe falciparum malaria.

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  • 1Department of Medicine, Chumphorn Hospital, Thailand.

Abstract

OBJECTIVE:

To compare the efficacy of exchange transfusion as the adjunct to quinine treatment (21 patients) with quinine therapy alone (29 patients).

METHOD:

A retrospective study of 50 patients with severe falciparum malaria was conducted at Chumphorn Hospital, Southern Thailand.

RESULTS:

Clinical characteristics in both treatment groups were not significantly different although in the exchange transfusion group, the admission geometric mean parasitaemia (18 (5%), and the proportion of patients with more than 10% parasitaemia was higher (76%, P = 0.03) than in the group who received quinine alone (10 +/- 4%; 38%, P = 0.1). The mortality rate of patients who received exchange transfusion was 48%; that of the remainder, 69%. (P = 0.3). ARDS (P = 0.01) and oliguric renal failure (P = 0.04) were significant risk factors for death in these patients.

CONCLUSION:

Exchange transfusion was safe and well tolerated. Results of our study revealed a 20% reduction in mortality when exchange transfusion was used as an adjunct to quinine treatment. It should therefore be considered in patients with severe falciparum malaria when possible.

PMID:
9537279
[PubMed - indexed for MEDLINE]
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