A Comparative Study of Acetated Isotonic Electrolyte Solution, Normal Saline Solution, And Lactated Ringer’s Solution In the Initial Fluid Resuscitation of Children 1 Month to 18 Years Old With Severe Dengue at The Philippine Children’s Medical Center

Allen Kilby  M. Palon,; Ervina  J. Astih,; Mary Joy  S. Torres,; Mellinor  A. Aspuria-Ang,

A Comparative Study of Acetated Isotonic Electrolyte Solution, Normal Saline Solution, And Lactated Ringer’s Solution In the Initial Fluid Resuscitation of Children 1 Month to 18 Years Old With Severe Dengue at The Philippine Children’s Medical Center

Allen Kilby M. Palon | Mary Joy S. Torres | Ervina J. Astih | Mellinor A. Aspuria-Ang

Abstract:

BACKGROUND: At PCMC, acetated isotonic electrolyte solution is used in the initial resuscitation in severe dengue patients. However, no local study has comparedacetated isotonic electrolyte solution against normal saline and lactated Ringer’s solutions. OBJECTIVE: This study aims to determine the comparative recovery time to achieve initial and sustained cardiovascular stability in severe dengue patients using acetated isotonic electrolyte solution, normal saline solution, and lactated Ringer’s solution. METHODOLOGY: This is a retrospective cohort study involving 166 severe dengue patients 1 month to 18 years old admitted at the PICU from 2014 to 2016. They were divided into 3 groups based on the initial fluid used: 58 in the AIES group, 58 in the NSS group, and 50 in the LRS group. RESULTS: AIES group had the shortest time to achieve initial and sustained stability among patients without re-shock. Also, AIES group needed less fluid to establish stability and had less re-shock, less use of colloid and inotropes, less blood transfusion,and less need for mechanical ventilation and dialysis. NSS had the most fluid shift to AIES and/or colloid while LRS had the most colloid used. Hyperchloremic metabolic acidosis was mostly seen in the NSS group. The length of ICU stay was almost the same in all groups. There was zero mortality in AIES group as compared to 3 on NSS group and 2 in LRS group. CONCLUSION AND RECOMMENDATION: Acetated isotonic electrolyte solution is more effectivethan normal saline and lactated Ringer’s solutions in initial fluid resuscitation among severe dengue patients. It should be the fluid of choice in the initial resuscitation among severe dengue patients. It is recommended that a randomized control study with more patients be conducted.

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