Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic Parameters
Background: Fluid resuscitation is the mainstay of treatment to counteract massive plasma leakage in dengue shock syndrome. We aimed to determine the differences in clinical outcomes and hemodynamic parameters of children with dengue shock syndrome post restrictive and liberal fluid resuscitation. ...
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| Format: | Article |
| Language: | English |
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Mashhad University of Medical Sciences
2019-04-01
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| Series: | International Journal of Pediatrics |
| Subjects: | |
| Online Access: | http://ijp.mums.ac.ir/article_12005_9fab306d4faba67be7c5e7f5efadaa90.pdf |
| _version_ | 1798041058169323520 |
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| author | Saptadi Yuliarto Kurniawan Kadafi Dessy Anitasari |
| author_facet | Saptadi Yuliarto Kurniawan Kadafi Dessy Anitasari |
| author_sort | Saptadi Yuliarto |
| collection | DOAJ |
| description | Background: Fluid resuscitation is the mainstay of treatment to counteract massive plasma leakage in dengue shock syndrome. We aimed to determine the differences in clinical outcomes and hemodynamic parameters of children with dengue shock syndrome post restrictive and liberal fluid resuscitation. Materials and Methods: A retrospective observational study of pediatric patients who were between one month to 18 years old, presented with clinical criteria for dengue hemorrhagic fever (DHF) grade III and IV based on WHO classification of dengue fever in 2011, and admitted to the Saiful Anwar General Hospital, Malang- Indonesia, from January 2016 to December 2016. Patients were divided in two groups: resuscitated with either 40ml/kg BW (liberal group) solutions; then we analyzed the clinical outcomes and hemodynamic parameters between two groups. Results Among 100 patients, 92 patients were classified as DHF grade III and 8 patients were DHF grade IV. 74 patients were in the restrictive group and 24 patients were in the liberal group. Median age at diagnosis was 6 years old, and 56% of patients were female. No significant differences were observed between length of stay in pediatric intensive care unit (P=0.09), and duration of ventilator use (P=0.68). The restrictive group had 53% lower mortality compared to the liberal group (P=0.18). This study also showed that there were no significant differences in hemodynamic parameters between two groups based on measurement with USCOM which were preload component (SVV) (P=0.89), inotropy components (SMII) (P=0.07), SVRI (P=0.85) as well as the cardiac index (P=0.66). Conclusion This study showed that there is no difference in clinical outcomes (length of mechanical ventilation and length of PICU stay), and hemodynamic parameters (preload, inotropy, afterload, and cardiac index) in Dengue Shock Syndrome patients who receive restrictive or liberal fluid resuscitation. |
| first_indexed | 2024-04-11T22:16:12Z |
| format | Article |
| id | doaj.art-3ccb8e638f3c4cb3b28fe839454aabb9 |
| institution | Directory Open Access Journal |
| issn | 2345-5047 2345-5055 |
| language | English |
| last_indexed | 2024-04-11T22:16:12Z |
| publishDate | 2019-04-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | International Journal of Pediatrics |
| spelling | doaj.art-3ccb8e638f3c4cb3b28fe839454aabb92022-12-22T04:00:22ZengMashhad University of Medical SciencesInternational Journal of Pediatrics2345-50472345-50552019-04-01749215922410.22038/ijp.2018.36587.318612005Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic ParametersSaptadi Yuliarto0Kurniawan Kadafi1Dessy Anitasari2Department of Pediatrics, Division of Pediatric Emergency and Intensive Care, Saiful Anwar General Hospital, University of Brawijaya, Malang, East of Java, Indonesia.Department of Pediatrics, Division of Pediatric Emergency and Intensive Care, Saiful Anwar General Hospital, University of Brawijaya, Malang, East of Java, Indonesia.Department of Pediatrics, Saiful Anwar General Hospital, University of Brawijaya, Malang, East of Java, Indonesia.Background: Fluid resuscitation is the mainstay of treatment to counteract massive plasma leakage in dengue shock syndrome. We aimed to determine the differences in clinical outcomes and hemodynamic parameters of children with dengue shock syndrome post restrictive and liberal fluid resuscitation. Materials and Methods: A retrospective observational study of pediatric patients who were between one month to 18 years old, presented with clinical criteria for dengue hemorrhagic fever (DHF) grade III and IV based on WHO classification of dengue fever in 2011, and admitted to the Saiful Anwar General Hospital, Malang- Indonesia, from January 2016 to December 2016. Patients were divided in two groups: resuscitated with either 40ml/kg BW (liberal group) solutions; then we analyzed the clinical outcomes and hemodynamic parameters between two groups. Results Among 100 patients, 92 patients were classified as DHF grade III and 8 patients were DHF grade IV. 74 patients were in the restrictive group and 24 patients were in the liberal group. Median age at diagnosis was 6 years old, and 56% of patients were female. No significant differences were observed between length of stay in pediatric intensive care unit (P=0.09), and duration of ventilator use (P=0.68). The restrictive group had 53% lower mortality compared to the liberal group (P=0.18). This study also showed that there were no significant differences in hemodynamic parameters between two groups based on measurement with USCOM which were preload component (SVV) (P=0.89), inotropy components (SMII) (P=0.07), SVRI (P=0.85) as well as the cardiac index (P=0.66). Conclusion This study showed that there is no difference in clinical outcomes (length of mechanical ventilation and length of PICU stay), and hemodynamic parameters (preload, inotropy, afterload, and cardiac index) in Dengue Shock Syndrome patients who receive restrictive or liberal fluid resuscitation.http://ijp.mums.ac.ir/article_12005_9fab306d4faba67be7c5e7f5efadaa90.pdfChildrenDengue Shock SyndromeLiberalFluid resuscitationRestrictive |
| spellingShingle | Saptadi Yuliarto Kurniawan Kadafi Dessy Anitasari Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic Parameters International Journal of Pediatrics Children Dengue Shock Syndrome Liberal Fluid resuscitation Restrictive |
| title | Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic Parameters |
| title_full | Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic Parameters |
| title_fullStr | Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic Parameters |
| title_full_unstemmed | Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic Parameters |
| title_short | Restrictive versus Liberal Fluid Resuscitation in Children with Dengue Shock Syndrome: the differences in Clinical Outcomes and Hemodynamic Parameters |
| title_sort | restrictive versus liberal fluid resuscitation in children with dengue shock syndrome the differences in clinical outcomes and hemodynamic parameters |
| topic | Children Dengue Shock Syndrome Liberal Fluid resuscitation Restrictive |
| url | http://ijp.mums.ac.ir/article_12005_9fab306d4faba67be7c5e7f5efadaa90.pdf |
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