Exchange Transfusion combined with Artesunate (ET-AS) as a safe and effective Therapy in Severe P. falciparum Malaria: A retrospective case series

Abstract

Abstract Background. The mortality associated with severe P. falciparum malaria remains high despite improvements in malaria management. This study aims to observe the efficacy and safety of the ET-AS regimen in severe P. falciparum malaria. Methods. Eight patients diagnosed with severe P. falciparum malaria were enrolled. All patients underwent ET using the COBE Spectra system. The aimed for a post-exchange hematocrit of 30%. Half the estimated blood volume was removed and replaced using fresh frozen plasma. Results. The regimen was well-tolerated without complications. The median parasite clearance time was 2.5 days. Five patients with cerebral malaria exhibited improved consciousness within 3 days. There was observed improvement in a patient presenting with hemolysis on Day 2. The median time of improved liver and renal function was 1.5 days and 10 days. The median length of intensive care unit (ICU) and hospital treatments was 3 days and 6 days. Conclusions. ET-AS improved the clinical picture and reduce the duration of hospitalization and ICU stays. These preliminary clinical data are valuable to practitioners and provide a basis for a randomized controlled trial of this therapy.