期刊论文详细信息
BMC Research Notes
Trends of fluid requirement in dengue fever and dengue haemorrhagic fever: a single centre experience in Sri Lanka
Manoji Pathirage1  Udaya K Ralapanawa1  Ruwan Munasinghe2  Kosala GAD Weerakoon3  Senanayake AM Kularatne1 
[1] Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka;Teaching Hospital, Peradeniya, Sri Lanka;Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
关键词: Fluid management;    Critical phase;    Dengue haemorrhagic fever;    Dengue fever;   
Others  :  1164298
DOI  :  10.1186/s13104-015-1085-0
 received in 2014-11-14, accepted in 2015-03-23,  发布年份 2015
PDF
【 摘 要 】

Background

Meticulous fluid management is the mainstay of treatment in dengue fever that is currently governed by consensus guidelines rather than by strong research evidence. To examine this issue we audited the fluid requirement of a cohort of adult patients with dengue fever (DF) and dengue haemorrhagic fever (DHF) in a tertiary care clinical setting.

Results

This retrospective cohort study was conducted from July 2012 to January 2013 in Teaching Hospital, Peradeniya, Sri Lanka. Adult patients with confirmed dengue infection managed according to the national and WHO guidelines were included. Their fluid requirement was audited once data collection was over in both DF and DHF groups. Out of 302 patients, 209 (69%) had serological confirmation of dengue infection, comprising 62 (30%) patients gone into critical phase of DHF. Mean age of the DHF group was 30 years (range 12-63 years) and included more males (n = 42, 68%, p < 0.05). Their mean duration of fever on admission and total duration of fever were 4 days and 6 days respectively. DHF group had high incidence of vomiting, abdominal pain and flushing, lowest platelet counts and highest haematocrit values compared to DF group. In DHF group, the mean total daily requirements of fluid from 2nd to 7th day were 2123, 2733, 2846, 2981, 3139 and 3154 milliliters respectively to maintain a safe haematocrit value and the vital parameters. However, in DF group the fluid requirement was lowest on 3rd day (2158 milliliters). DHF group had significantly high fluid requirement on 5th -7th day compared to DF group (p < 0.05).

Conclusions

Patients in critical phase of DHF required a higher volume of fluids from the 3rd day of fever and again on 5th to 7th day of fever. Despite being an audit, these finding could be useful in future updates of guidelines and designing research.

【 授权许可】

   
2015 Kularatne et al.; licensee BioMed Central.

【 预 览 】
附件列表
Files Size Format View
20150414021620663.pdf 686KB PDF download
Figure 3. 35KB Image download
Figure 2. 26KB Image download
Figure 1. 26KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]World Health Organization Regional office for South East Asia: Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever revised and expanded edition. World Health Organization South East Asia World Health Organization South East Asia regional office, New Delhi; 2011.
  • [2]Leo YS, Thein TL, Fisher DA, Low JG, Oh HM, Narayanan RL, et al.: Confirmed adult dengue deaths in Singapore: 5-year multi-center retrospective study. BMC Infect Dis 2011, 11:123. BioMed Central Full Text
  • [3]Malavige GN, Fernando S, Fernando DJ, Seneviratne SL: Dengue viral infections. Postgrad Med J 2004, 80:588-601.
  • [4]Kularatnea SA, Seneviratne SL, Malavige GN, Fernando S, Velathanthiri VG, Ranatunga PK, et al.: Synopsis of findings from recent studies on dengue in Sri Lanka. Dengue Bulletin 2006, 30:80-6.
  • [5]Weerakoon KGAD, Kularatne SAM, Edussuriya DH, Kodikara SKA, Gunatilake LPG, Pinto VG, et al.: Histopathological diagnosis of myocarditis in a dengue outbreak in Sri Lanka. BMC Res Notes 2011, 4:268. BioMed Central Full Text
  • [6]Ministry of Health Sri Lanka, in collaboration with Ceylon College of Physicians: Guidelines on clinical management of dengue fever and dengue haemorrhagic fever in adults. Ministry of Health, Sri Lanka; 2010.
  • [7]Harris E, Pérez L, Phares CR, Pérez Mde L, Idiaquez W, Rocha J, et al.: Fluid intake and decreased risk for hospitalization for dengue fever. Nicaragua Emerg Infect Dis 2003, 9(8):1003-6.
  • [8]Kularatne SA, Gawarammana IB, Kumarasiri PR: Epidemiology, clinical features, laborotory investigations and early diagnosis of dengue fever in adults: a descriptive study in Sri Lanka. Southeast Asian J Trop Med Public Health 2005, 36:686-92.
  • [9]Bhaskar M, Moorthy S, Kumar NS, Arthur P: Dengue haemorrhagic fever among adults – An observational study in Chennai, south India. Indian J Med Res 2010, 132:738-40.
  • [10]Seet RC, Ooi EE, Wong HB, Paton NI: An outbreak of primary dengue infection among migrant Chinese workers in Singapore characterized by prominent gastrointestinal symptoms and a high proportion of symptomatic cases. J Clin Virol 2005, 33:336-40.
  • [11]Weerakoon KGAD, Chandrasekaram S, Jayabahu JPSNK, Gunasena S, Kularatne SAM: Acute abdominal pain in dengue haemorrhagic fever: A study in Sri Lanka. Dengue Bulletin 2009, 33:70-4.
  • [12]Malavige GN, Velathanthiri VGNS, Wijewickrama ES, Fernando S, Jayaratne SD, Jayaratne SD, et al.: Patterns of disease among adults hospitalized with dengue infections. Q J Med 2006, 99:299-305.
  • [13]Potts JA, Gibbons RV, Rothman AL, Srikiatkhachorn A, Thomas SJ, Supradish PO, et al.: Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. PLoS Negl Trop Dis 2010, 4:e769.
  • [14]Saito M, Oishi K, Inoue S, Dimaano EM, Alera MT, Robles AM, et al.: Association of increased platelet-associated immunoglobulins with thrombocytopenia and the severity of disease in secondary dengue virus infections. Clin Exp Immunol 2004, 138:299-303.
  • [15]Wills B, Tran VN, Nguyen TH, Truong TT, Tran TN, Nguyen MD, et al.: Hemostatic changes in Vietnamese children with mild dengue correlate with the severity of vascular leakage rather than bleeding. Am J Trop Med Hyg 2009, 81(4):638-44.
  • [16]Jameel T, Mehmood K, Mujtaba G, Choudhry N, Afzal N, Paul RF: Changing haematological parameters in dengue viral infections. J Ayub Med Coll Abbottabad 2012, 24(1):3-6.
  • [17]Premaratna R, Ragupathy A, Miththinda JK, de Silva HJ: Timing, predictors, and progress of third space fluid accumulation during preliminary phase fluid resuscitation in adult patients with dengue. Int J Infect Dis 2013, 17(7):e505-9.
  • [18]Kittigul L, Pitakarnjanakul P, Sujirarat D, Siripanichgon K: The 10 differences of clinical manifestations and laboratory findings in children and adults with dengue virus infection. J Clin Virol 2007, 39(2):76-81.
  • [19]Martina BE, Koraka P, Osterhaus AD: Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev 2009, 22:564-81.
  • [20]Limonta D, Capo V, Torres G, Perez AB, Guzman MG: Apoptosis in tissues from fatal dengue shock syndrome. J Clin Virol 2007, 40:50-4.
  • [21]Lin CF, Lei HY, Shiau AL, Liu CC, Liu HS, Yeh TM, et al.: Antibodies from dengue patient sera cross-react with endothelial cells and induce damage. J Med Virol 2003, 69:82-90.
  • [22]Dalrymple NA, Mackow ER: Endothelial cells elicit immune-enhancing responses to dengue virus infection. J Virol 2012, 86:6408-15.
  文献评价指标  
  下载次数:24次 浏览次数:4次