{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:40:21Z","timestamp":1791042021733,"version":"4.1.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about children undergoing critical care for malaria. The purpose of this survey was to evaluate the outcome in African children requiring endotracheal intubation for life-threatening malaria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All children with a primary diagnosis of severe malaria (2000 WHO definition) requiring endotracheal intubation, hospitalised over a five-year period, within a tertiary-care hospital in Dakar, Senegal, were enrolled in a retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      83 consecutive patients were included (median PRISM h\n                      <jats:sub>24<\/jats:sub>\n                      score: 14; IQR: 10\u201319, multiple organ dysfunctions: 91.5%). The median duration of ventilation was 36 hrs (IQR: 4\u201372). Indications for intubation were deep coma (Glasgow score \u22647, n = 16), overt cortical or diencephalic injury, i.e, status epilepticus\/decorticate posturing (n = 20), severe brainstem involvement, i.e., decerebrate posturing\/opisthotonus (n = 15), shock (n = 15), cardiac arrest (n = 13) or acute lung injury (ALI) (PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      &lt;300 Torr, n = 4). Death occurred in 50 cases (case fatality rate (CFR), 60%) and was associated with multiple organ dysfunctions (median PELOD\n                      <jats:sub>h24<\/jats:sub>\n                      scores: 12.5 among non-survivors\n                      <jats:italic>versus<\/jats:italic>\n                      11 among survivors, p = 0.02). Median PRISM\n                      <jats:sub>h24<\/jats:sub>\n                      score was significantly lower when testing deep coma against other indications (10\n                      <jats:italic>vs<\/jats:italic>\n                      15, p &lt; 0.001), ditto for PELOD\n                      <jats:sub>h24<\/jats:sub>\n                      score (2.5\n                      <jats:italic>vs<\/jats:italic>\n                      13, p = 0.02). Multivariate analysis identified deep coma as having a better outcome than other indications (CFR, 12.5%\n                      <jats:italic>vs<\/jats:italic>\n                      40.0 to 93.3%, p &lt; 0.0001). Decerebrate posturing\/opisthotonus (CFR 73.3%, adjusted relative risk (aRR) 10.7, 95% CI 2.3\u201349.5) were associated with a far worse prognosis than status epilepticus\/decorticate posturing (CFR 40.0%, aRR 5.7, 95% CI 1.2\u201327.1). Thrombocytopaenia (platelet counts &lt;100,000\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ) was associated with death (aRR 2.6, 95% CI 1.2\u20135.8) and second-line anticonvulsant use (clonazepam or thiopental) with survival (aRR 0.4, 95% CI 0.2\u20130.9). Complications, mostly nosocomial infections (n = 20), ALI\/ARDS (n = 9) or sub-glottic stenosis (n = 3), had no significant prognostic value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In this study, the outcome of children requiring intubation for malaria depends more on clinical presentation and progression towards organ failures than on critical care complications\n                      <jats:italic>per se<\/jats:italic>\n                      . In sub-Saharan Africa, mechanical ventilation for life-threatening childhood malaria is feasible, but seems unlikely to dramatically improve the prognosis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/1475-2875-6-51","type":"journal-article","created":{"date-parts":[[2007,5,1]],"date-time":"2007-05-01T02:13:26Z","timestamp":1177985606000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Outcome of life-threatening malaria in African children requiring endotracheal intubation"],"prefix":"10.1186","volume":"6","author":[{"given":"Patrick","family":"G\u00e9rardin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Rogier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadou S","family":"Ka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Jouvencel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bakary","family":"Diatta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Imbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2007,4,30]]},"reference":[{"key":"356_CR1","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1016\/S0140-6736(05)71877-8","volume":"365","author":"J Bryce","year":"2005","unstructured":"Bryce J, Boschi-Pinto C, Shibuya K, Black RE, the WHO Child Health Epidemiology Reference Group: WHO estimates of the causes of death in children. 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