The effect of Ringer’s acetate versus Ringer’s lactate on aminotransferase changes in dengue hemorrhagic fever
Keywords:
hepatocellular impairment, dengue haemorrhagic fever, Ringer’s acetate, Ringer’s lactate, aminotransferase
Abstract
Background Dengue hemorrhagic fever (DHF) infection causeshepatocelullar 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
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rhage in dengue without circulatory collapse. Am J Trop
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H, Hung NT, et al. Liver histopathology and biological
correlates in five cases of fatal dengue fever in Viet-
namese children. Virchows Arch 2001;438:107-15.
24. Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou
SS, Liaw YF. Liver biochemical tests and dengue fever.
Am J Trop Med Hyg 1992;47:265-70.
25. Nguyen TL, Nguyen TH, Tieu NT. The impact of den-
gue haemorrhagic fever on liver function. Res Virol
1997;148:273-7.
26. Mohan B, Patwari AK, Anand VK. Hepatic dysfunc-
tion in childhood dengue infection. J Trop Pediatr
2000;46:40-3.
27. Johnston DE. Special considerations in interpreting liver
function tests. Am Fam Physician 1999;59:2223-30.
28. Wang LY, Chang WY, Lu SN, Chen TP. Sequential
changes of serum transaminase and abdominal
sonography in patients with suspected dengue fever [ab-
stract]. Gaoxiong Yi Xue Ke Xue Za Zhi 1990;6:483-9.
29. Nguyen TH, Lei HY, Nguyen TL, Lin YS, Huang KJ,
Le BL, et al. Dengue hemorrhagic fever in infants: a
study of clinical and cytokine profiles. J Infect Dis
2004;189:221-32.
30. Pancharoen C, Rungsarannont A, Thisyakorn U. Hepatic
dysfunction in dengue patients with various severity [ab-
stract]. J Med Assoc Thai 2002;85 (Suppl): 298-301.
31. Martin P, Friedman LS. Assessment of liver function
and diagnostic studies. In: Friedman LS, Keeffe EB,
editors. Handbook of liver disease. 1st ed. London:
Churchill Livingstone; 1998. p. 1-4.
32. Maller ES. Laboratory assessment of liver function and
injury in children. In: Suchy FJ, editor. Liver disease in
children. 1st ed. Missouri: Mosby; 1994. p. 269-80.
33. Ganong WF. Keseimbangan energi, metabolisme dan
nutrisi. In: Ganong WF, editor. Fisiologi kedokteran.
10th ed. Jakarta: ECG Penerbit Buku Kedokteran;
1988. p. 236-270.
penyakit demam berdarah dengue, perhatian khusus
pada syok, produksi TNF-a, Interleukin-6, dan sebagai
faktor prediktor demam berdarah dengue berat [disser-
tation]. Jakarta: Universitas Indonesia; 1996. p. 12-14.
2. Soedarmo SP. Demam berdarah dengue. Medika
1995;10:798-808.
3. Soedarmo SP. Masalah demam berdarah dengue di
Indonesia. In: Harun SR, Satari HI, editors. Demam
berdarah dengue, naskah lengkap pelatihan bagi
pelatih dokter spesialis anak dan dokter spesialis
penyakit dalam dalam tatalaksana kasus demam
berdarah dengue. 1st ed. Jakarta: Balai Penerbit FKUI;
1999. p. 1-5.
4. Bethell DB, Gamble J, Pham PL, Nguyen MD, Tran TH,
Ha TH, et al. Noninvasive measurement of microvascu-
lar leakage in patients with dengue haemorrhagic fever.
Clin Infect Dis 2001; 32:243-53.
5. Wahid SF, Sanusi S, Zawawi MM, Ali RA. A compari-
son of the pattern of liver involvement in dengue hem-
orrhagic fever with classic dengue fever. Southeast
Asian J Trop Med Public Health 2000;31:259-63.
6. Harun SR, Soegijanto S, Wuryadi S, Suroso T.
Tatalaksana demam dengue/demam berdarah dengue
pada anak. In: Harun SR, Satari HI, editors. Demam
berdarah dengue, naskah lengkap pelatihan bagi pelatih
dokter spesialis anak dan dokter spesialis penyakit
dalam dalam tatalaksana kasus demam berdarah den-
gue. 1st ed. Jakarta: Balai Penerbit FKUI; 1999. p. 82-
137.
7. Kurane I, Ennis FA. Cytokines in dengue virus infec-
tions: role of cytokines in the pathogenesis of dengue
haemorrhagic fever. Semin Virology 1994;5:443-8.
8. Harun SR. Imunopatogenesis demam berdarah den-
gue. In: Akib AA, Tumbelaka AR, Matondang CS,
editors. Naskah lengkap PKB IKA XLIV: Pendekatan
imunologi berbagai penyakit alergi dan infeksi. Jakarta:
Balai Penerbit FKUI; 2001. p. 41-57.
9. World Health Organization. Dengue hemorrhagic fe-
ver: diagnosis, treatment, prevention, and control. 2nd
ed. Geneva: WHO; 1997. p. 1-33.
10. World Health Organization. Guidelines for treatment
of dengue fever/dengue haemorrhagic fever in small
hospitals. 1st ed. New Delhi: WHO Regional Office
for South-East Asia; 1999. p. 16-8.
11. Latief A. Pemilihan cairan resusitasi pada anak:
kontroversi antara koloid dan kristaloid. In: Chair I,
Purwanto SH, Pudjiadi A, editors. Naskah lengkap PKB
IKA XXX: Pendekatan farmakologik pada pediatri gawat
darurat. Jakarta: Bagian Ilmu Kesehatan Anak Fakultas
Kedokteran Universitas Indonesia; 1993. p. 37-50.
12. Sunatrio S. Resusitasi cairan. 1st ed. Jakarta: Media
Aesculapius FKUI, 2000. p. 1-120.
13. Sunatrio S. Larutan Ringer asetat dalam praktek klinis.
Presented at Simposium Alternatif Baru dalam Terapi
Resusitasi Cairan; 1999 Aug 14; Jakarta, Indonesia.
14. Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I,
Purwanto SH. Perkiraan besar sampel. In: Sastroasmoro S,
Ismael S, editors. Dasar-dasar metodologi penelitian klinis.
2nd edition. Jakarta: Sagung Seto; 2002. p. 259-86.
15. Suvatte V, Vajaradul C, Laohapand. Liver failure and
hepatic encephalopathy in dengue hemorrhagic fever/
dengue shock syndrome: correlation study with ac-
etaminophen usage. Southeast Asian J Trop Med Public
Health 1990;21:694-5.
16. Innis BL. Acute liver failure is one important cause of
fatal dengue infection. Southeast Asian J Trop Med
Public Health 1990;21:695-6.
17. Soedarmo SP. Patofisiologi dan patogenesis. In:
Sumarmo, editor. Demam berdarah dengue pada anak.
2nd ed. Jakarta: FKUI; 1988. p. 27-33.
18. Harun SR, Soegijanto S, Wuryadi S, Suroso T. Tatalaksana
demam dengue/ demam berdarah dengue. 1st ed. Jakarta:
Ditjen P2MPLP Departemen Kesehatan RI; 1999. p. 1-6.
19. Juffrie M, Haasnoot K, Thijs LG. Dengue virus infec-
tion and dengue hemorrhagic shock. Crit Care and
Shock 2000;3:139-45.
20. Chameides L, Hazinski MR. Recognition of respiratoy
failure and shock. In: Aehlert B, editor. Pediatric Ad-
vanced Life Support. St Louis: Mosby; 1997. p. 1– 10.
21. Lin YL, Liu CC, Lei HY, Yeh TM, Lin YS, Chen RM, et
al. Infection of five human liver cell lines by dengue-2
virus. J Med Virol 2000; 60:425-31.
22. Krishnamurti C, Kalayanarooj S, Cutting MA, Peat RA,
Rothwell SW, Reid TJ, et al. Mechanisms of hemor-
rhage in dengue without circulatory collapse. Am J Trop
Med Hyg 2001;65:840-7.
23. Huerre MR, Lan NT, Marianneau P, Hue NB, Khun
H, Hung NT, et al. Liver histopathology and biological
correlates in five cases of fatal dengue fever in Viet-
namese children. Virchows Arch 2001;438:107-15.
24. Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou
SS, Liaw YF. Liver biochemical tests and dengue fever.
Am J Trop Med Hyg 1992;47:265-70.
25. Nguyen TL, Nguyen TH, Tieu NT. The impact of den-
gue haemorrhagic fever on liver function. Res Virol
1997;148:273-7.
26. Mohan B, Patwari AK, Anand VK. Hepatic dysfunc-
tion in childhood dengue infection. J Trop Pediatr
2000;46:40-3.
27. Johnston DE. Special considerations in interpreting liver
function tests. Am Fam Physician 1999;59:2223-30.
28. Wang LY, Chang WY, Lu SN, Chen TP. Sequential
changes of serum transaminase and abdominal
sonography in patients with suspected dengue fever [ab-
stract]. Gaoxiong Yi Xue Ke Xue Za Zhi 1990;6:483-9.
29. Nguyen TH, Lei HY, Nguyen TL, Lin YS, Huang KJ,
Le BL, et al. Dengue hemorrhagic fever in infants: a
study of clinical and cytokine profiles. J Infect Dis
2004;189:221-32.
30. Pancharoen C, Rungsarannont A, Thisyakorn U. Hepatic
dysfunction in dengue patients with various severity [ab-
stract]. J Med Assoc Thai 2002;85 (Suppl): 298-301.
31. Martin P, Friedman LS. Assessment of liver function
and diagnostic studies. In: Friedman LS, Keeffe EB,
editors. Handbook of liver disease. 1st ed. London:
Churchill Livingstone; 1998. p. 1-4.
32. Maller ES. Laboratory assessment of liver function and
injury in children. In: Suchy FJ, editor. Liver disease in
children. 1st ed. Missouri: Mosby; 1994. p. 269-80.
33. Ganong WF. Keseimbangan energi, metabolisme dan
nutrisi. In: Ganong WF, editor. Fisiologi kedokteran.
10th ed. Jakarta: ECG Penerbit Buku Kedokteran;
1988. p. 236-270.
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 19Apr.2024];45(2):81-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/805
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Received 2016-10-05
Accepted 2016-10-05
Published 2016-10-10
Accepted 2016-10-05
Published 2016-10-10
