Exchange Transfusion Therapy in Severe Complicated Malaria
MONGKOL PINANONG, M.D.*
Affiliation : * Division of Medicine, Petchabun Hospital, Petchabun 67000, Thailand.
Abstract Two groups of sixteen cases of severe complicated falciparum malaria on two different regimens of treatment were retrospectively studied. The first group including 12 patients, were treated by anti malarial drugs alone. The second group including 4 patients, were treated by exchange transfusion. Multisystemic complications were observed in both groups. It was observed that in complicated Acute Respiratory Distress Syndrome (ARDS), renal and hyperparasitemia were >30 per cent. The result of the exchange transfusion group was superior to the non exchange group. Exchange transfusion is therefore recommended in the treatment of malarial patiel)tS who present with parasitemia >30 per cent and severe multisystemic complications paticularly those who have severe acute renal failure or have lung complications. The amount of blood used for each exchange transfusion shoulrl be at least 10-14 units for rapid removal of parasites and toxic metabolites from the circulation.
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