A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria
Background: Optimising the fluid resuscitation of patients with severe malaria is a simple and potentially cost-effective intervention. Current WHO guidelines recommend central venous pressure (CVP) guided, crystalloid based, resuscitation in adults. Methods: Prospectively collected haemodynamic dat...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2011
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| _version_ | 1797104695274110976 |
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| author | Nguyen, H Hanson, J Bethell, D Nguyen, T Tran, T Ly, VC Pham, P Sinh, D Dondorp, A White, N Hien, T Day, N |
| author_facet | Nguyen, H Hanson, J Bethell, D Nguyen, T Tran, T Ly, VC Pham, P Sinh, D Dondorp, A White, N Hien, T Day, N |
| author_sort | Nguyen, H |
| collection | OXFORD |
| description | Background: Optimising the fluid resuscitation of patients with severe malaria is a simple and potentially cost-effective intervention. Current WHO guidelines recommend central venous pressure (CVP) guided, crystalloid based, resuscitation in adults. Methods: Prospectively collected haemodynamic data from intervention trials in Vietnamese adults with severe malaria were analysed retrospectively to assess the responses to fluid resuscitation. Results: 43 patients were studied of whom 24 received a fluid load. The fluid load resulted in an increase in cardiac index (mean increase: 0.75 L/min/m2 (95% Confidence interval (CI): 0.41 to 1.1)), but no significant change in acid-base status post resuscitation (mean increase base deficit 0.6 mmol/L (95% CI: -0.1 to 1.3). The CVP and PAoP (pulmonary artery occlusion pressure) were highly inter-correlated (rs = 0.7, pand0.0001), but neither were correlated with acid-base status (arterial pH, serum bicarbonate, base deficit) or respiratory status (PaO2/FiO2 ratio). There was no correlation between the oxygen delivery (DO2) and base deficit at the 63 time-points where they were assessed simultaneously (rs=-0.09, p=0.46). Conclusions: In adults with severe falciparum malaria there was no observed improvement in patient outcomes or acid-base status with fluid loading. Neither CVP nor PAoP correlated with markers of end-organ perfusion or respiratory status, suggesting these measures are poor predictors of their fluid resuscitation needs. © 2011 Phu et al. |
| first_indexed | 2024-03-07T06:37:12Z |
| format | Journal article |
| id | oxford-uuid:f80d330c-bd92-481b-a248-95f8f97bd077 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:37:12Z |
| publishDate | 2011 |
| record_format | dspace |
| spelling | oxford-uuid:f80d330c-bd92-481b-a248-95f8f97bd0772022-03-27T12:47:40ZA retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malariaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f80d330c-bd92-481b-a248-95f8f97bd077EnglishSymplectic Elements at Oxford2011Nguyen, HHanson, JBethell, DNguyen, TTran, TLy, VCPham, PSinh, DDondorp, AWhite, NHien, TDay, NBackground: Optimising the fluid resuscitation of patients with severe malaria is a simple and potentially cost-effective intervention. Current WHO guidelines recommend central venous pressure (CVP) guided, crystalloid based, resuscitation in adults. Methods: Prospectively collected haemodynamic data from intervention trials in Vietnamese adults with severe malaria were analysed retrospectively to assess the responses to fluid resuscitation. Results: 43 patients were studied of whom 24 received a fluid load. The fluid load resulted in an increase in cardiac index (mean increase: 0.75 L/min/m2 (95% Confidence interval (CI): 0.41 to 1.1)), but no significant change in acid-base status post resuscitation (mean increase base deficit 0.6 mmol/L (95% CI: -0.1 to 1.3). The CVP and PAoP (pulmonary artery occlusion pressure) were highly inter-correlated (rs = 0.7, pand0.0001), but neither were correlated with acid-base status (arterial pH, serum bicarbonate, base deficit) or respiratory status (PaO2/FiO2 ratio). There was no correlation between the oxygen delivery (DO2) and base deficit at the 63 time-points where they were assessed simultaneously (rs=-0.09, p=0.46). Conclusions: In adults with severe falciparum malaria there was no observed improvement in patient outcomes or acid-base status with fluid loading. Neither CVP nor PAoP correlated with markers of end-organ perfusion or respiratory status, suggesting these measures are poor predictors of their fluid resuscitation needs. © 2011 Phu et al. |
| spellingShingle | Nguyen, H Hanson, J Bethell, D Nguyen, T Tran, T Ly, VC Pham, P Sinh, D Dondorp, A White, N Hien, T Day, N A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria |
| title | A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria |
| title_full | A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria |
| title_fullStr | A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria |
| title_full_unstemmed | A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria |
| title_short | A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria |
| title_sort | retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in vietnamese adults with severe falciparum malaria |
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