Figure 2

Suggested fluid management for adults with severe malaria. All of the proposed supportive care measures may not be available at sites where patients with severe malaria are initially managed. Early transfer to centers where these services are available is indicated, when possible. Maintenance fluid: the suggested 1 to 2 mL/kg per hour should take into consideration and include other administered fluids: antibiotic therapy, vasopressor infusions, and so on. Crystalloid: Based on plasma electrolytes, consider balanced solutions if available. Fluid bolus: 5 mL/kg crystalloid over 15 minutes; titrate bolus frequency against clinical response. APO, acute pulmonary edema; IV, intravenous; MAP, mean arterial pressure; RRT, renal replacement therapy, hemofiltration preferred if available.