Fresh insights into Ebola treatment show new ways of hydrating patients in critical care environments across the world.
The review, that includes 17 studies involving 885 people, compares the different ways to give fluids to people in situations where it is impossible to maintain adequate hydration simply by giving fluids orally.
Collectively, these alternatives are termed parenteral access. They include getting fluids into a vein (intravenously), into bone marrow (intraosseously), into fatty tissue under the skin (subcutaneously) or into the abdominal space (intraperitoneally).
"This review shows us that if intravenous access can be achieved easily, then this should be used as it allows the infusion of larger volumes of fluid. However, if intravenous access is not possible, intraosseous and subcutaneous routes are alternatives that can be inserted quickly," said study author Katharine Ker from The London School of Hygiene and Tropical Medicine.
Many patients with Ebola Virus Disease (EVD) die because they are dehydrated. Patients with EVD often experience severe vomiting and diarrhoea, which causes them to lose fluids which are difficult to replace by drinking alone.
Giving fluids intravenously is a commonly used method, but in patients with Ebola this can be problematic.
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Obtaining venous access can be difficult in very dehydrated patients, and this is made even worse in situations where care-givers are obliged to wear protective suits, and where there is a risk of transmission of the virus, such as Ebola.
This review helps health workers caring for patients with EVD to know the advantages and disadvantages of the other ways to give fluids, so they can decide which is the most suitable for their patients.
The findings were published in Cochrane Library.