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Acidosis of severe falciparum malaria: heading for a shock?

Kathryn Maitland1, Charles R J C Newton

  • 1The Centre for Geographic Medicine Research, Coast, KEMRI, Kenya, PO Box 230, Kilifi, Kenya. kmaitland@kilifi.mimcom.net

Trends in Parasitology
|January 11, 2005
PubMed

Insights

Severe malaria in children often causes metabolic acidosis and shock, presenting a treatment challenge. Volume expansion is explored as a potential therapy for this life-threatening condition.

Area of Science:

  • Pediatric infectious diseases
  • Critical care medicine
  • Malariology

Background:

  • Severe Plasmodium falciparum malaria shares features with sepsis, particularly metabolic acidosis.
  • Metabolic acidosis is a key predictor of mortality in severe malaria across all age groups.
  • Intravascular hypovolemia (shock) frequently accompanies malarial acidosis in children.

Purpose of the Study:

  • To review clinical trials on volume expansion for children with severe malaria.
  • To assess the safety and efficacy of fluid resuscitation in malarial acidosis with cerebral malaria.

Main Methods:

  • Systematic review of recent clinical trials.
  • Analysis of data on volume expansion in pediatric severe malaria patients.
  • Evaluation of outcomes in children with acidosis and impaired consciousness.

Main Results:

  • Volume expansion is a common intervention for shock in severe malaria.
  • Evidence suggests potential benefits of fluid resuscitation in this population.
  • Further research is needed to optimize treatment strategies.

Conclusions:

  • Volume expansion is a critical consideration in managing pediatric severe malaria with acidosis and shock.
  • Therapeutic decisions must balance potential benefits against risks in critically ill children.
  • Understanding the pathophysiology of malarial acidosis is essential for effective treatment.

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