The effect of Ringer’s acetate versus Ringer’s lactate on aminotransferase changes in dengue hemorrhagic fever

  • Mulya Rahma Karyanti
  • Hindra Irawan Satari
  • Damayanti Rusli Sjarif
Keywords: hepatocellular impairment, dengue haemorrhagic fever, Ringer’s acetate, Ringer’s lactate, aminotransferase

Abstract

Background Dengue hemorrhagic fever (DHF) infection causes
hepatocelullar impairment. In management of DHF, World Health
Organization (WHO) recommends the crystalloids Ringer’s acetate
(RA) or Ringer’s lactate (RL), which are similar in composition to
plasma. Acetate in RA is not metabolized in the liver, hence not
burdening the liver, whereas lactate in RL is metabolized mostly in
the liver, thus placing a burden on the liver.
Objective To compare aminotransferase changes as markers of
hepatocellular impairment subsequent to the use of RA and RL in
the management of DHF with and without shock.
Methods This study was a double-blind randomized controlled
trial on DHF patients aged 1-18 years in Cipto Mangunkusumo
Hospital who had not received prior treatment with crystalloids or
colloids. Subjects were randomly assigned to receive either RA or
RL intravenously. Aminotransferase levels were examined on the
first, second and third weeks from the onset of fever.
Results Ninety-two patients who fulfilled inclusion criteria were
enrolled in this study, consisting of those without and with shock.
Mean transaminase levels of patients without shock in the RA and
RL groups did not differ significantly. Mean transaminase levels of
patients with shock in the RA group were lower than those in the
RL group, but this difference was not significant statistically. Mean
alteration of transaminase levels in patients with and without shock
were not significantly different.
Conclusion In DHF without shock, there is no significant differ-
ence between aminotransferase level changes of patients receiv-
ing RA and RL solutions. In DHF with shock, aminotransferase
levels of patients receiving RA tend to be lower than those receiv-
ing RL, but this difference is insignificant

Author Biographies

Mulya Rahma Karyanti
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Hindra Irawan Satari
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Damayanti Rusli Sjarif
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

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Published
2016-10-10
How to Cite
1.
Karyanti M, Satari H, Sjarif D. The effect of Ringer’s acetate versus Ringer’s lactate on aminotransferase changes in dengue hemorrhagic fever. PI [Internet]. 10Oct.2016 [cited 13Nov.2024];45(2):81-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/805
Section
Articles
Received 2016-10-05
Accepted 2016-10-05
Published 2016-10-10