E-Mail karger@karger.com In-Depth Review Blood Purif 2014;38:276–285 DOI: 10.1159/000371530 Preparing for Renal Replacement Therapy in Patients with the Ebola Virus Disease Sarah Faubel   a Harold Franch   b Anitha Vijayan   c Michelle A. Barron   d Michael Heung   e Kathleen D. Liu   f Jay L. Koyner   g Michael J. Connor Jr.   h a  University of Colorado Denver and VA Medical Center, Renal Division, Denver, Colo., b  Emory University School of Medicine, Division of Renal Medicine, Research Service, Atlanta Department of Veterans Affairs Medical Center, Atlanta, Ga., c  Washington University St. Louis, St. Louis, Mo., d  University of Colorado, Denver, Division of Infectious Diseases, Denver, Colo., e  University of Michigan, Department of Medicine, Division of Nephrology, Ann Arbor, Mich., f  Departments of Medicine and Anesthesia, University of California, San Francisco, San Francisco, Calif., g  Section of Nephrology, Department of Medicine, University of Chicago, Chicago, Ill., h  Divisions of Pulmonary, Allergy and Critical Care & Renal Medicine, Emory University School of Medicine, Atlanta, Ga., USA tient outcome and prevention of transmission of disease to health care workers, we extensively discussed the modes of Ebola virus transmission and recommended protocols to protect health care workers. Experience now indicates that with appropriate planning and protocols, it is possible to successfully treat EVD patients with advanced supportive care (mechanical ventilation and RRT) while avoiding trans- mission to health care providers. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=371530. © 2015 S. Karger AG, Basel Introduction Ebola virus disease (EVD) was first identified in 1976. Between 1976 and 2012, multiple, small-scale EVD out- breaks with a total of approximately 1,700 confirmed cas- es occurred – primarily in isolated remote villages of Central Africa [1–3]. The current EVD outbreak is cen- tered in West Africa primarily affecting Guinea, Liberia, and Sierra Leone and is thought to have begun in Guinea in December 2013. As of January 7, 2015, the World Key Words Renal replacement therapy · Ebola virus disease · Biocontainment facility Abstract The Ebola virus disease (EVD) is a serious illness character- ized by fever, severe vomiting and diarrhea, and, in severe cases, multi-organ failure requiring mechanical ventilation and renal replacement therapy. The current outbreak has centered in West Africa and affected over 15,000 individuals. EVD is transmitted by direct contact with blood or other in- fectious bodily fluid, and as such, numerous heath care workers caring for patients with EVD have become infected. During the current outbreak, a number of patients have re- ceived advanced supportive care for EVD in Europe and North America and therefore survived. Now, many hospitals in Europe and North America are planning to accept care for patients with EVD. In this review, we discussed the key issues related to the planning and delivery of advanced supportive care in patients with EVD with a focus on the factors neces- sary to provide renal replacement therapy (RRT). Since suc- cess in the treatment of patients with EVD rests on both pa- Published online: February 11, 2015 Sarah Faubel, MD University of Colorado Denver and Denver VA Medical Center International Medicine, Renal Division 12700 East 19th Ave, Box Cs81, Aurora, CO 80045 (USA) E-Mail sarah.faubel  @  ucdenver.edu © 2015 S. Karger AG, Basel 0253–5068/15/0384–0276$39.50/0 www.karger.com/bpu Downloaded from http://karger.com/bpu/article-pdf/38/3-4/276/2289800/000371530.pdf by guest on 16 October 2023