Comparison of blood plasma and gelatin solution in resuscitation of children with dengue shock syndrome
Keywords:
dengue shock syndrome, resuscitation, gelatin, plasma
Abstract
Background Dengue shock syndrome (DSS) is characterized bysevere vascular leakage and hemostasis disorder. It is the cause of death in 1 to 5 percent of cases. WH 0 management guidelines for resuscitation remain empirical rather than evidence-based.
Objective To find out the alternative fluids to replace plasma
leakage in DSS.
Methods We performed a prospective study and randomized
comparison of plasma and gelatin solution for resuscitation of
Indonesian children with DSS. We randomly assigned 25 subjects
with DSS to receive plasma and 25 children to receive gelatin
fluid. Statistical analyse were performed using chi-square test,
Fisher's exact test, t test, Mann-Whitney test.
Results The increment of pulse pressure width and the decrement of hematocrit in subjects treated with gelatin were higher than that of plasma atfour-hour therapy (P=0.002 and P=0.017). Only one patient died caused by unusually manifestation of DSS. The increment of body temperature in subjects treated with plasma was higher than that of gelatin at four-hour therapy (P=O.Oll). The decrement of platelet count in subjects treated with gelatin were less than that of plasma (P=0.018). The increment of diuresis rate in subjects treated with gelatin was higher than that of plasma at twenty-hour therapy (P<O.OOOl). The decrement of respiratory rate in subjects treated with gelatin was higher than that of plasma
at twenty-eight hour therapy (P=0.018). There was no difference
in studied variables : total volume rate, blood pressure, pulse rate, re-shock rate, clinical fluid overload, allergy reactions, bleeding manifestations, and length of stay (P>0.05).
Conclusions Gelatin solution can be used as volume replacement
in resuscitation of DSS if blood plasma is not available especially
at four-hour therapy.
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In: Gubler DJ, Kuno G, editors. Dengue and dengue
haemorrhagic fever. Walingford, England: CAB International,
1997: p. 23-44.
3. Srisakul CK, Suchitra N, Ananda N, Donald SB. Evidence
that maternal dengue antibodies are important in the
development of dengue hemorrhagic fever in infant. Am J
Trop Med Hyg. 1988;38:411-9.
4. Sumarmo. Demam berdarah dengue pada anak. [Dissertation]. Jakarta: UI Press, 1983.
5. Gubber OJ. Dengue and dengue hemorrhagic fever. Clin
Microbial Rev. 1998;11:1-14.
6. Sutaryo. Dengue. Yogyakarta : Medika FK UGM, 2004; p.
4,32,65-78,156-83,184-207.
7. Djoharman S, Samsi TK. Demam berdarah dengue
berat dengan konfirmasi virologik. CDK edisi khusus.
1992;81:40-3.
8. 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 EnglJ Med. 2005.
[cited on 2006 Januari 22]353:877-89. Available from http://
nejm.org.
9. WHO. Technical guides for diagnosis, treatment, surveillance,
prevention and control of dengue haemorrhagic fever.
Technical advisory committee on dengue haemorrhagic fever
for South-East Asian and Western Pacific Region; 1975.
10. Setiati TE. Pengelolaan syok pada demam berdarah dengue.
In : Sutaryo, Pudjo HW, Mulatsih S. Tatalaksana syok dan
perdarahan pada DB D. Yogyakarta: Medika FK UGM, 2004;
p. 75-85.
11. Ong EL. A case of hypersensitivity to gelafundin. Singapore
MedJ. 2001;42:176-7.
12. WHO. Guidelines for treatment of dengue fever/dengue
haemorrhagic fever in small hospital. New Delhi : WHO,
Regional Office for South East Asia, 1999; p. 1-10.
13. Ngo 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.
14. 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 intravenousfluid
regimens. Clin Infect Dis. 1999;29:787-94.
15. Putjiadi A. Koloid dan kristaloid. In :Trihono P, Purnawati
S, Syarif DR. Hot topics in pediatrics II. Jakarta, 2002; p.
121-33.
16. Composition of colloid solutions and blood products. 2006.
[cited on 2006 October 14]; 1:4. Available from : http://
homepage.ed.ac.uk/asb/SHOA2/composition-of-colloidsolutions.htm.
17. Ganong WF. Buku ajar fisiologi kedokteran (translation).
17th ed. Philadelphia: WB Saunders, 1999; p. 523-4.
18. Samsi MK, Yang JS. Tidak adanya hubungan langsung berat
molekul dengan besarnya ukuran molekul cairan koloid
untuk resusitasi sindroma syok dengue. In: Sadjimin T, J uf&ie
M, Julia M, Wibowo T,editors. Abstract PIT IKA III,2007.
Yogyakarta: PIT IKA III IDAI/Bagian IKA FK-UGM/Institut
Kesehatan Anak RSUP Dr. Sarjito, 2007; p.l 7.
19. Sumarmo. Infeksi virus dengue. In : Sumarmo, Garna H,
Hadinegoro SRS,editors. Buku ajar ilmu kesehatan anak.
Jakarta :Bagian ilmu kesehatan anak FKUI, 2002; p.177-208.
20. Rampengan TH. Demam berdarah dengue. In: Rampengan
TH, Laments IR, editors. Penyakit infeksi tropik pada anak.
Jakarta: EGC, 1992; p.135-55.
21. Dronen SC. Plasma and volume expanders. In: Barsan WG,
J astremski MS, Syverut SA, editors. Emergency drug therapy.
Philadelphia: WB Saunders company, 1991; p. 50-68.
22. Darell J, Triulzi. Use and abuse of fresh frozen plasma.
[cited on 1997 March]; 1-3. Available from: www.itxm.org/
tmul997/tmu3-97.htm.
23. Ring], Laubenthal H, Mebmer K. Incidence and classification
of adverse reactions to plasma substitutes. JMM. 2005:997-1002.
Published
2009-12-31
How to Cite
1.
Tatura S, Rampengan N, Mandei J, Runtunuwu A, Mantik M, Rampengan T. Comparison of blood plasma and gelatin solution in resuscitation of children with dengue shock syndrome. PI [Internet]. 31Dec.2009 [cited 22Dec.2024];49(6):322-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/591
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Received 2016-09-11
Accepted 2016-09-11
Published 2009-12-31
Accepted 2016-09-11
Published 2009-12-31
