Treatment of Ebola Virus Disease with Severe Dehydration (>10% Volume Depletion), No Shock

This page addresses the clinical management of Ebola virus disease in patients who present with severe dehydration — defined as greater than 10% volume depletion — in the absence of shock.

Clinical scenario

The patient has Ebola virus disease and meets criteria for severe dehydration (more than 10% volume depletion) without haemodynamic shock. Correcting significant fluid deficit is the immediate clinical priority in this presentation.

Treatment approach

The protocol centres on structured intravenous fluid therapy. Fluid selection, target total volume, and administration differ by patient age group. The protocol also specifies when and how oral rehydration may accompany IV access, and defines criteria for reassessment and rate adjustment. The complete regimen and algorithm are in the full protocol.

Clinical goal

Improvement of hydration status.

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References

Patients without shock but with severe dehydration (see Section 2.4 Fluid status)
Start IV fluid therapy with 0.9% saline with dextrose or Ringer's lactate with dextrose (see also Appendix 2).
If patient can drink, give ORS by sips while IV is being set up.
Determine amount of IV fluid to be given: 100 ml/kg.
Re-assess child every 15–30 minutes. If hydration status not improving, give fluids more rapidly.

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