• François Lamontagne, Robert A Fowler, Neill K Adhikari, Srinivas Murthy, David M Brett-Major, Michael Jacobs, Timothy M Uyeki, Constanza Vallenas, Susan L Norris, William A Fischer, Thomas E Fletcher, Adam C Levine, Paul Reed, Daniel G Bausch, Sandy Gove, Andrew Hall, Susan Shepherd, Reed A Siemieniuk, Marie-Claude Lamah, Rashida Kamara, Phiona Nakyeyune, Moses J Soka, Ama Edwin, Afeez A Hazzan, Shevin T Jacob, Mubarak Mustafa Elkarsany, Takuya Adachi, Lynda Benhadj, Christophe Clément, Ian Crozier, Armando Garcia, Steven J Hoffman, and Gordon H Guyatt.
• Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada; Centre de recherche du CHUS de Sherbrooke, Sherbrooke, QC, Canada. Electronic address: francois.lamontagne@usherbrooke.ca.
• Lancet. 2018 Feb 17; 391 (10121): 700-708.

AbstractThe 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units. Key recommendations include administration of oral and, as necessary, intravenous hydration; systematic monitoring of vital signs and volume status; availability of key biochemical testing; adequate staffing ratios; and availability of analgesics, including opioids, for pain relief.Copyright © 2018 Elsevier Ltd. All rights reserved.

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