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Ebola Doctors Are Divided on IV Therapy in Africa

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Medical experts seeking to stem the
Ebola epidemic are sharply divided
over whether most patients in West
Africa should, or can, be given
intravenous hydration, a therapy that is
standard in developed countries. Some
argue that more aggressive treatment
with IV fluids is medically possible and
a moral obligation. But others counsel
caution, saying that pushing too hard
would put overworked doctors and
nurses in danger and that the
treatment, if given carelessly, could
even kill patients.
The debate comes at a crucial time in
the outbreak. New infections are
flattening out in most places, better-
equipped field hospitals are opening,
and more trained professionals are
arriving, opening up the possibility of
saving many lives in Africa, rather than
a few patients flown to intensive care
units thousands of miles away.
The World Health Organization sees
intravenous rehydration, along with
constant measuring of blood chemistry,
as the main reason that almost all
Ebola patients treated in American and
European hospitals have survived,
while about 70 percent of those treated
in West Africa have died.
Every hospital there should have “early,
liberal use of intravenous fluid and
electrolyte replacement,” said Dr.
Robert A. Fowler, a Canadian critical
care specialist who leads a W.H.O.
Ebola team. Anything less, he said, is
“not medically justified and will result
in continued high case-fatality rates.” read more on NYT

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