Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 19 , ISSUE 4 ( 2015 ) > List of Articles

REVIEW ARTICLE

Exchange transfusion in complicated pediatric malaria: A critical appraisal

Himesh Barman

Keywords : Exchange blood transfusion, parasite index, pediatric intensive care unit, red cell exchange, severe falciparum malaria

Citation Information : Barman H. Exchange transfusion in complicated pediatric malaria: A critical appraisal. Indian J Crit Care Med 2015; 19 (4):214-219.

DOI: 10.4103/0972-5229.154554

License: CC BY-ND 3.0

Published Online: 00-04-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Complicated falciparum malaria is a killer disease resulting in high mortality in spite of appropriate treatment. Some workers have reported improved survival when adjunct exchange blood transfusion is included in the treatment modality while others opine against it. This review is an effort to address and critically appraise current evidence for the treatment mode for severe malaria. The literature was searched with a specified search strategy to identify reports of children who underwent exchange transfusion for severe malaria. Total 23 children who underwent exchange transfusion for severe falciparum malaria published by 9 authors were identified. Age ranged from 5 months to 16 years with a mean age of 6.4 years. The average preprocedure parasite index (PI) was 41.4% (95confidence interval [CI]; 31.2-51.4). The average blood volume exchanged was 118.6% (95% CI; 94.7-143) of the circulating blood volume. The average postexchange reduction in PI was 34.1% (95% CI; 25.4-42.8). Three out of 23 children encountered some complications. All the children survivedKeywords: Exchange blood transfusion, parasite index, pediatric Intensive Care Unit, red cell exchange, severe falciparum malaria.


PDF Share
  1. World Health Organization. Treatment of severe falciparum malaria. In: Guideline for Treatment of Malaria. Geneva: World Health Organization; 2006. p. 41-61.
  2. McKenzie FE, Jeffery GM, Collins WE. Plasmodium malariae blood-stage dynamics. J Parasitol 2001;87:626-37.
  3. McKenzie FE, Jeffery GM, Collins WE. Plasmodium vivax blood-stage dynamics. J Parasitol 2002;88:521-35.
  4. Gilles HM. The malaria parasites. In: Gilles HM, Warrell DA, editors. Bruce-Chwatt′s Essential Malariology. London, Boston, Melbourne, Auckland: Edward Arnold; 1993. p. 12-34.
  5. Krogstad DJ. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and Practice of Infectious Diseases. New York: Churchill Livingstone; 1995. p. 2415-27.
  6. McQueen PG, McKenzie FE. Age-structured red blood cell susceptibility and the dynamics of malaria infections. Proc Natl Acad Sci U S A 2004;101:9161-6.
  7. Newton CR, Krishna S. Severe falciparum malaria in children: Current understanding of pathophysiology and supportive treatment. Pharmacol Ther 1998;79:1-53.
  8. Cooke BM, Mohandas N, Coppel RL. Malaria and the red blood cell membrane. Semin Hematol 2004;41:173-88.
  9. Clark IA, Budd AC, Alleva LM, Cowden WB. Human malarial disease: A consequence of inflammatory cytokine release. Malar J 2006;5:85.
  10. Maegraith B. Other pathological processes in malaria. Bull World Health Organ 1974;50:187-93.
  11. Trampuz A, Jereb M, Muzlovic I, Prabhu RM. Clinical review: Severe malaria. Crit Care 2003;7:315-23.
  12. White NJ, Pongtavornpinyo W, Maude RJ, Saralamba S, Aguas R, Stepniewska K, et al. Hyperparasitaemia and low dosing are an important source of anti-malarial drug resistance. Malar J 2009;8:253.
  13. Powell VI, Grima K. Exchange transfusion for malaria and Babesia infection. Transfus Med Rev 2002;16:239-50.
  14. Beards SC, Joynt GM, Lipman J. Haemodynamic and oxygen transport response during exchange transfusion for severe falciparum malaria. Postgrad Med J 1994;70:801-4.
  15. Kumar S, Karnad DR, Vaingankar J, Thatte UM, Krishnan A, Rege NN. Serum tumour necrosis factor alpha levels in severe malaria: Effect of partial exchange transfusion. Intensive Care Med 2003;29:1857-8.
  16. Hall A, Yardumian A, Marsh A. Exchange transfusion and quinine concentrations in falciparum malaria. Br Med J (Clin Res Ed) 1985;291:1169-70.
  17. Pinanong M. Exchange transfusion therapy in severe complicated malaria. J Med Assoc Thai 1997;80:332-7.
  18. Srichaikul T, Leelasiri A, Polvicha P, Mongkonsritragoon W, Prayoonwiwat W, Leelarsupasri S, et al. Exchange transfusion therapy in severe complicated malaria. Southeast Asian J Trop Med Public Health 1993;24 Suppl 1:100-5.
  19. Hoontrakoon S, Suputtamongkol Y. Exchange transfusion as an adjunct to the treatment of severe falciparum malaria. Trop Med Int Health 1998;3:156-61.
  20. Looareesuwan S, Phillips RE, Karbwang J, White NJ, Flegg PJ, Warrell DA. Plasmodium falciparum hyperparasitaemia: Use of exchange transfusion in seven patients and a review of the literature. Q J Med 1990;75:471-81.
  21. Gulprasutdilog S, Chongkolwatana V, Buranakitjaroen P, Jaroonvesama N. Exchange transfusion in severe falciparum malaria. J Med Assoc Thai 1999;82:1-8.
  22. Boctor FN. Red blood cell exchange transfusion as an adjunct 296 treatment for severe pediatric falciparum malaria, using automated 297 or manual procedures. Pediatrics 2005;116:592-5.
  23. Shanbag P, Juvekar M, More V, Vaidya M. Exchange transfusion in children with severe falciparum malaria and heavy parasitaemia. Ann Trop Paediatr 2006;26:199-204.
  24. Fraser IP, Cserti CM, Dzik WH. Case records of the Massachusetts General Hospital. Case 32-2006. A 3-year-old girl with fever after a visit to Africa. N Engl J Med 2006;355:1715-22.
  25. Rego SJ, Subba Rao SD, Hejmadi A, Rekha S. Partial exchange transfusion as an adjunct to the treatment of severe falciparum malaria in children. J Trop Pediatr 2001;47:118-9.
  26. Weir EG, King KE, Ness PM, Eshleman SH. Automated RBC exchange transfusion: Treatment for cerebral malaria. Transfusion 2000;40:702-7.
  27. Boctor FN, Ali NM, Choi YJ, Morse EE. Exchange transfusion with red blood cells preserved in adenine clears a child of severe falciparum malaria. Ann Clin Lab Sci 1997;27:193-5.
  28. Deshpande A, Kalgutkar S, Udani S. Red cell exchange using cell separator (therapeutic erythrocytapheresis) in two children with acute severe malaria. J Assoc Physicians India 2003;51:925-6.
  29. Zhang Y, Telleria L, Vinetz JM, Yawn D, Rossmann S, Indrikovs AJ. Erythrocytapheresis for Plasmodium falciparum infection complicated by cerebral malaria and hyperparasitemia. J Clin Apher 2001;16:15-8.
  30. Macallan DC, Pocock M, Robinson GT, Parker-Williams J, Bevan DH. Red cell exchange, erythrocytapheresis, in the treatment of malaria with high parasitaemia in returning travellers. Trans R Soc Trop Med Hyg 2000;94:353-6.
  31. Udani S, Deshpande A, Kalgutkar S. Exchange transfusion for severe malaria: A comparisison of red cell exchange with whole blood exchange. Indian J Crit Care Med 2003;7:124-7.
  32. Mordmüller B, Kremsner PG. Hyperparasitemia and blood exchange transfusion for treatment of children with falciparum malaria. Clin Infect Dis 1998;26:850-2.
  33. Burchard GD, Kröger J, Knobloch J, Hartmann WJ, Eichenlaub D, Moling O, et al. Exchange blood transfusion in severe falciparum malaria: Retrospective evaluation of 61 patients treated with, compared to 63 patients treated without, exchange transfusion. Trop Med Int Health 1997;2:733-40.
  34. Riddle MS, Jackson JL, Sanders JW, Blazes DL. Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: A meta-analysis. Clin Infect Dis 2002;34:1192-8.
  35. Kreeftmeijer-Vegter AR, Melo Mde M, de Vries PJ, Koelewijn R, van Hellemond JJ, van Genderen PJ. Manual blood exchange transfusion does not significantly contribute to parasite clearance in artesunate-treated individuals with imported severe Plasmodium falciparum malaria. Malar J 2013;12:115.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.