Noninvasive Mechanical Ventilation in Lung Injury Secondary to Malaria
Malaria is an infectious disease caused by one or more of several species of the protozoan parasite Plasmodium including P. falciparum, P. vivax, P. ovale, P. malariae [1] and occasionally other Plasmodium species, notably monkey malaria P. knowlesi [2].
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Dipesh Maskey and Ritesh Agarwal
Keywords
Malaria • ARDS • ALI • Acute respiratory distress syndrome • Plasmodium • Falciparum • Vivax
12.1
Introduction
Malaria is an infectious disease caused by one or more of several species of the protozoan parasite Plasmodium including P. falciparum, P. vivax, P. ovale, P. malariae [1] and occasionally other Plasmodium species, notably monkey malaria P. knowlesi [2]. The infection is primarily transmitted by the bite of an infected Anopheles mosquito but may also be transmitted via transfusion of infected blood products and congenitally. Malaria is a global public health problem with the highest burden in tropical and subtropical countries including India. In 2010, an estimated 3.3 billion population were at risk for malaria, with 216 million cases diagnosed and 655,000 deaths. Most deaths occurred in African children [3]. India accounts for 66 % of the 2.4 million confirmed malaria cases in Southeast Asia, with P. falciparum causing 50 % of them. Malaria is imported into temperate zones, with 10,000 cases per year in western Europe and approximately 1,500 cases per year in the United States [4, 5]. Although malaria is a preventable and treatable disease, controlling and eradicating the disease remain elusive goals. Malaria has protean manifestations, from fever with nonspecific symptoms to life-threatening complications including acute respiratory distress syndrome (ARDS) [6–8]. Traditionally, P. falciparum was considered the causative agent for all forms of severe malaria [6]. Over the last two decades, multiple case reports and D. Maskey • R. Agarwal (*) Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, India e-mail: [email protected]; [email protected] A.M. Esquinas (ed.), Noninvasive Ventilation in High-Risk Infections and Mass Casualty Events, 109 DOI 10.1007/978-3-7091-1496-4_12, © Springer-Verlag Wien 2014
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D. Maskey and R. Agarwal
series have been published in which P. vivax—once considered benign—had infected patients who had severe, life-threatening complications including ARDS [9–15]. Initially, severe malaria due to vivax was believed to result from a mixed Plasmodium infection, with the severe manifestations caused by P. falciparum. There is now sufficient evidence that infection with P. vivax alone can cause severe malarial manifestations [17]. There are also reports of P. ovale [17, 18], P. malariae [19], and P. knowlesi [2, 20] causing a severe form of the disease including ARDS. In recent years, there has been a paradigm shift in the presentation of severe malaria. Multi-organ failure (including renal failure, hepatic failure, and ARDS) is being increasingly reported, unlike earlier presentations of severe malaria [16, 21–24]. Noninvasive ventilation (NIV) is the delivery of positive-pressure ventilation without an endotracheal airway to patients with acute respiratory failure. It is usually administered through a tight-fitting oronasal mask (less often nasally or wit
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