Comparison of the efficacy and safety of hydroxyethyl starch 130/0.4 and Ringer's lactate in children with grade III dengue hemorrhagic fever
Abstract
Background Theoretically hydroxyethyl starch (HES) will givemore rapid recovery from shock, including in dengue shock
syndrome (DSS) and currently gained popularity for its less
deleterious effects on renal function and blood coagulation.
Objectives To compare the efficacy and safety ofHES 130/0.4 and
Ringer's lactate (RL) for shock recovery in children with DSS.
Methods A randomized controlled study was performed on 39
children admitted with DSS at Dr. Soetomo Hospital, Surabaya,
between March and May 2007. Children were grouped into
grade III (n=25) and grade IV (n=14) dengue hemorrhagic
fever (DHF) according to the WHO criteria. Within each
group, subjects were randomly assigned to receive initial fluid
resuscitation with either HES 130/0.4 (n=9 in the DHF grade III
group, 10 in the DHF grade IV) or RL (n= 16 in the DHF grade
III group, 4 in the DHF grade IV). Clinical and laboratory data
were collected to determine improvements in shock recovery and
adverse reactions.
Results In both the grades III and IV DHF, HES 130/0.4
significantly decreased hemoglobin and hematocrit levels. Clinical
improvements in pulse pressure and pulse rate were seen after
treatment with HES 130/0.4 although these were statistically
insignificant if compared to the RL group. No differences in fluid
requirement and recurrent shock episodes were noted between
the RL and HES groups. No adverse reactions were found during
the study.
Conclusion HES 130/0.4 administration is effective and safe in
children with DSS.
References
children with dengue hemorrhagic fever. Paediatr lndones.
2004;44: 171-5.
2. Wills BA, Dung NM, Loan HT, Tam DTH, Thuy TTN,
Minh LTT, et al. Comparison of three fluid solutions for
resuscitation in dengue shock syndrome. N Eng! J Med.
2005;353:877-89.
3. Dung NM, Day NPJ, Tam DTH, Loan HT, Chau HTT,
Minh LN. Fluid replacement in dengue shock syndrome: a
randomized, double-blind comparison of four intravenousfluid
regimens. Clin Infect Dis. 1999;29:787-94.
4. Nhan NT, Cao XT, Kneen R, Wills B, Nguyen VM, Nguyen
TQ, et al. Acute management of dengue shock syndrome: a
randomized double-blind comparison of 4 intravenous fluid
regimens in the first hour. Clin Infect Dis. 2001;32: 204-
13.
5. Setiati TE. Pengelolaan syok pada demam berdarah dengue
anak. In: Sutaryo, Hagung P, Mulatsih S, editors. Tatalaksana
syok dan perdarahan pada DBD. Yogyakarta: Medika Medical
School ofGadjah Mada University, 2004; p.75-86.
6. Soegijanto S. Aspek klinis infeksi virus dengue di era tahun
2005-2006 dan tatalaksananya. Lecture for undergraduate
medical students in seventh semester of Hang Tuah University
Surabaya. 2005. Unpublished.
7. Darwis D. Kegawatan Demam Berdarah Dengue pada anak.
In: Hadinegoro SRS, Satari HI, editors. Demam Berdarah
Dengue. Naskah lengkap. Pelatihan bagi pelatih dokter
spesialis anak dan dokter spesialis penyakit dalam dalam
tatalaksana kasus DBD. Jakarta: Balai Penerbit Fakultas
Kedokteran Universitas Indonesia, 1999; p.1-12.
8. World Health Organization. Dengue haemorrhagic fever :
diagnosis, treatment and control. Geneva, 1997; p.1 7-2 7.
9. Aribowo ILF. Penggunaan dextran + ringer laktat pada
demam berdarah dengue derajat III : perbandingan antara
terapi dextran + ringer laktat dengan terapi plasma pada
demam berdarah dengue derajat III. [Thesis]. Surabaya:
Airlangga University;1993.
10. Skelett S, Mayer A, Durward A, Tibby SM, Murdoch
A. Chasing the base deficit: hyperchloraemic acidosis
following 0.9% saline fluid resuscitation. Arch Dis Child.
2000;83 :514-6.
11. Brill SA, Stewart TR, Brundage SI, Schreiber MA. Base
deficit does not predict mortality when secondary to
hyperchloremic acidosis. Shock. 2002; 17 (6) :459-62.
12. Woloszczuk-Gt
leads to metabolic acidosis and significant dyselectrolytemia
in a child. Anaesth Int Therapy. 2006;38: 143-6.
13. Rani PU, Naidu MUR, Rao SM, Murthy VSSN, Kumar TR,
Shobha JC, et al. Evaluation of clinical efficacy and safety of
hydroxyethyl starch. Indian J Pharmacal. 1996;28: 181-4.
14. Treib J, Baron JF, Grauer MT, Strauss RG. An international
view of hydroxyethyl starches. Intensive Care Med.
1999;25:258-68.
15. Fresenius Kabi. Yoluven®: Colloids approved for use in
children- Scientific information. Germany, 2004;10-103.
16. Grocott MPW, Hamilton MA. Resuscitation fluids. Vox Sang.
2002;2: 1-8.
17. Setiati TE. Koloid versus kristaloid. In: Lubis M, Supriatmo,
Nafianti S, editors. International Symposium Pediatric
Challenge 2006 - Facing The Challenge of Infection and
Emergency in Pediatrics. Medan : Indonesian Pediatric
Society North Sumatera Branch, 2006; p.190-206.
18. Sutaryo. Pengelolaan pasien. In : Sutaryo, editor. Dengue.
Yogyakarta : Medika Medical School of Gadjah Mada
University, 2004; p.156-83.
19. Warren BB, Durieux ME. Hydroxyethyl starch: safe or not?
Anesth Analg. 1997; 84:206-12.
20. Ti.irkan H, Ural AU, Beyan C, Yal~in A. Effects of
hydroxyethyl starch on blood coagulation profile. Eur J
Anaesth. 1999;16:156-9.
21. Treib J, Baron JF, Grauer MT, Strauss RG. An international
view of hydroxyethyl starches. Intensive Care Med.
1999;25:258-68.
22. Christidis C, Mal F, Ramos J, Senejoux A, Callard P, Navarro
R, et al. Worsening of hepatic dysfunction as a consequence
of repeated hydroxyethylstarch infusions. J Hepatol. 2001 ;35:
726-32.
23. Waters JH, Bernstein CA. Dilutional acidosis following
hetastarch or albumin in healthy volunteers. Anesthesiology.
2001;9: 1184-7.
24. Latief A. Pemilihan cairan resusitasi pad a anak : Kontroversi
antara koloid dan kristaloid. In : Chair I, Purwanto SH,
Pudjiadi A, editors. Pendidikan Kedokteran Berkelanjutan
Ilmu Kesehatan Anak Fakultas Kedokteran Universitas
Indonesia: Pendekatan Farmakologik Pada Pediatri Gawat
Darurat. Jakarta: Department of Child Health Medical
School of Indonesia University, 1993; p. 37-50.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2016-09-10
Published 2009-04-30