Comparison of gelatin and HES 130/0.4 solution for fluid resuscitation in children with dengue shock syndrome
Abstract
Background Dengue shock syndrome (DSS) is characterized
by severe vascular leakage and hemostasis disorder, which causes
death in 1-5% of cases. World Health Organization management
guidelines for fluid resuscitation in DSS remain empirical, rather
than evidence-based.
Objective To as sess the efficacy of ge latin compared to
hydroxyethyl starch (HES) 130/0.4 solution for fluid resuscitation
in children with DSS.
Methods We performed a multi-centered, randomized study to
compare gelatin and HES 130/0.4 solution for resuscitation of
children with DSS. We randomly assigned 25 children with DSS
to receive gelatin fluid and 25 children to receive HES 130/0.4.
Statistical analyses were performed using Chi-square and MannWhitney
tests.
Results More rapid increase in pulse pressure was noted in
subjects treated with HES 130/0.4 compared to those treated
with gelatin at 8 hours and 28 hours of therapy (P=0.037 and
P=0.048). The decrease in hematocrit in subjects treated with
HES 130/0.4 was faster than that of gelatin at 4 hours of therapy
(P=0.001). One patient died due to an unusual manifestation of
DSS. Respiratory rate decreased faster in subjects treated with
HES 130/0.4 than those treated with gelatin at 4 hours and 8
hours of therapy (P< 0.05). Body temperature remained higher
in subjects treated with gelatin than HES 130/0.4 at 36 hours and
48 hours of therapy (P< 0.05). However, the decrease in platelet
counts in subjects treated with HES 130/0.4 was more than that
of gelatin (P=0.018).
Conclusion HES 130/0.4 solution may be better for volume replacement
compared to gelatin and is safe for fluid resuscitation
in children with DSS.
References
and control. 2"d ed. Geneva: WHO; 1997.
2. Halstead SB. Epidemiology of dengue haemorrhagic fever.
In: Gubler DJ, Kuna G, editors. Dengue and dengue
haemorrhagic fever. England: CAB Int; 1997. p. 23-44.
3. Rampengan TH. Demam berdarah dengue. In: Rampengan
TH, Laurens IR, editors. Penyakit infeksi tropik pada anak.
Jakarta: EGC; 2002. p.135-55.
4. Setiati T E. Pengelolaan syok pada demam berdarah dengue.
In: Sutatyo, Pudjo HW, Mulatsih S, editors. Tatalaksana syok
clan perdarahan pada DBD. Yogyakarta: Medika FK UGM;
2004. p. 75-85.
5. Sumarrno. Demam berdarah dengue pada anak [dissertation].
Uakarta): UI Press; 1983; p. 20-5.
6. Dung NM, Day NP, Tam DT, Loan HT, Chau HT, Minh
LN, et al. Fluid replacement in dengue shock syndrome: a
randomized, double-blind comparison of four intravenous fluid
regimens. Clin Infect Dis. 1999;29:787-94.
7. Ngo NT, Cao J, Kneen R, Wills B, Ngyuyen VM, Ngyuyen
TQ, et al. Acute management of dengue shock syndrome: a
randomized double-blind comparison of four intravenous fluid
regimens in the first hour. Clin Infect Dis. 2001;32:204-13.
8. Barclay L, Lie D. Ringer's lactate maybe quivalent to colloid
for maderate dengue shock syndrome in children. N Engl J
Med. 2005 ;363 :57 7 -89.
9. Wills BA, Nguyen MD, Ha TL, Dong TH, Tran TN, Le TT,
et al. Comparison of three fluid solutions for resuscitation in
dengue shock syndrome. N Engl J Med. 2005 ;353:877-89.
10. Prasetyo RV, Aziz AL, Soegijanto S. Comparison of efficacy
and safety ofhydroxyethyl starch 130/0.4 and Ringer's lactate
in children with grade III dengue hemorrhagic fever. Paediatr
Indones. 2009;49:103.
11. Pudjiadi A. Koloid clan kristaloid. In: Trihono P, Purnawati
S, Syarif DR, editors. Hot topics in pediatrics II. Jakarta:
PUBLISHER. 2002; p. 121-133.
12. Beards SC, Watt T, Edwards JP, Nightingale P, Farragher
EB. Comparison of the hemodynamic and oxygen transport
responses to modified fluid gelatin and hetastarch in critically
ill patients: a prospective, randomized trial. Crit Care Med.
1994;22:600-5.
13. Sumpelmann R, Kretz FJ, Gabler R, Luntzer R, Baroncini
S, Osterkorn D, et al. Hydroxyethyl starch 130/0.42/6: l
for perioperative plasma volume replacement in children :
preliminary results of a European prospective multicenter
observational postauthorization safety study (PASS). Paediatr
Anaesth. 2008; 18:929-33.
14. Laxenaire M, Verra MD, Jalac SL. The use ofcolloids and crystalloids
in pediatric dengue shock syndrome: a systematic review
and meta-analysis. Intensive Care Med. 20 10;39: 14-25.
15. Boldt J, Preibe HJ. Intravascular volume replacement therapy
with synthetic colloids: is there an influence on ren al
function? Anesth Analg. 2003 ;96:3 7 6-82.
16. Molyneux EM, Maitland K. Intravenous fluids-getting the
balance right. N EnglJ Med. 2005;353: 941-4.
17. Sumpelmann R, Witt L, Brutt M, Osterkorn D, Koppert
W, Osthaus WA. Chan ges in acid-base, electrolyte and
hemoglobin concentrations during infusion ofhydroxyethyl
starch 130/0 .42/6: l in normal saline or in balanced
electrolyte solu tion in children. Paediatr Anaesth.
20 10;20 :100-4.
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Accepted 2016-08-29
Published 2013-12-30
