J Med Assoc Thai 1997; 80 (5):332

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Exchange Transfusion Therapy in Severe Complicated Malaria
Pinanong M Mail

Two groups of sixteen cases of severe complicated falciparum malaria on two different
regimens of treatment were retrospectively studied. The first group including 12 patients, were
treated by anti malarial drugs alone. The second group including 4 patients, were treated by
exchange transfusion. Multisystemic complications were observed in both groups. It was observed
that in complicated Acute Respiratory Distress Syndrome (ARDS), renal and hyperparasitemia
were >30 per cent. The result of the exchange transfusion group was superior to the non exchange
group. Exchange transfusion is therefore recommended in the treatment of malarial patiel)tS who
present with parasitemia >30 per cent and severe multisystemic complications paticularly those
who have severe acute renal failure or have lung complications. The amount of blood used for
each exchange transfusion shoulrl be at least 10-14 units for rapid removal of parasites and toxic
metabolites from the circulation.

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