Journal Article

Acute Management of Dengue Shock Syndrome: A Randomized Double-Blind Comparison of 4 Intravenous Fluid Regimens in the First Hour

Ngo Thi Nhan, Cao Xuan Thanh Phuong, Rachel Kneen, Bridget Wills, Nguyen Van My, Nguyen Thi Que Phuong, Chu Van Thien, Nguyen Thi Thuy Nga, Julie A. Simpson, Tom Solomon, Nicholas J. White and Jeremy Farrar

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 2, pages 204-213
Published in print January 2001 | ISSN: 1058-4838
Published online January 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318479
Acute Management of Dengue Shock Syndrome: A Randomized Double-Blind Comparison of 4 Intravenous Fluid Regimens in the First Hour

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Dengue hemorrhagic fever is an important cause of morbidity among Asian children, and the more severe dengue shock syndrome (DSS) causes a significant number of childhood deaths. DSS is characterized by a massive increase in systemic capillary permeability with consequent hypovolemia. Fluid resuscitation is critical, but as yet there have been no large trials to determine the optimal fluid regimen. We undertook a randomized blinded comparison of 4 fluids (dextran, gelatin, lactated Ringer's, and “normal” saline) for initial resuscitation of 230 Vietnamese children with DSS. All the children survived, and there was no clear advantage to using any of the 4 fluids, but the longest recovery times occurred in the lactated Ringer's group. The most significant factor determining clinical response was the pulse pressure at presentation. A comparison of the colloid and crystalloid groups suggested benefits in children presenting with lower pulse pressures who received one of the colloids. Further large-scale studies, stratified for admission pulse pressure, are indicated.

Journal Article.  5807 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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