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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/49642
Title: Associations Between Restrictive Fluid Management and Renal Function and Tissue Perfusion in Adults With Severe Falciparum Malaria: A Prospective Observational Study
Authors: Haruhiko Ishioka
Katherine Plewes
Rajyabardhan Pattnaik
Hugh W.F. Kingston
Stije J. Leopold
M. Trent Herdman
Kishore Mahanta
Anita Mohanty
Chandan Dey
Shamsul Alam
Ketsanee Srinamon
Akshaya Mohanty
Richard J. Maude
Nicholas J. White
Nicholas P.J. Day
Md Amir Hossain
Md Abul Faiz
Prakaykaew Charunwatthana
Sanjib Mohanty
Aniruddha Ghose
Arjen M. Dondorp
Jichi Medical University
Ispat General Hospital
Harvard T.H. Chan School of Public Health
Institute of Life Sciences India
Mahidol University
Nuffield Department of Clinical Medicine
Chittagong Medical College
Dev Care Foundation
Keywords: Medicine
Issue Date: 2-Jan-2020
Citation: The Journal of infectious diseases. Vol.221, No.2 (2020), 285-292
Abstract: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. BACKGROUND: Liberal fluid resuscitation has proved harmful in adults with severe malaria, but the level of restriction has not been defined. METHODS: In a prospective observational study in adults with severe falciparum malaria, restrictive fluid management was provided at the discretion of the treating physician. The relationships between the volume of fluid and changes in renal function or tissue perfusion were evaluated. RESULTS: A total of 154 patients were studied, 41 (26.6%) of whom died. Median total fluid intake during the first 6 and 24 hours from enrollment was 3.3 (interquartile range [IQR], 1.8-5.1) mL/kg per hour and 2.2 (IQR, 1.6-3.2) mL/kg per hour, respectively. Total fluid intake at 6 hours was not correlated with changes in plasma creatinine at 24 hours (n = 116; rs = 0.16; P = .089) or lactate at 6 hours (n = 94; rs = -0.05; P = .660). Development of hypotensive shock or pulmonary edema within 24 hours after enrollment were not related to the volume of fluid administration. CONCLUSIONS: Restrictive fluid management did not worsen kidney function and tissue perfusion in adult patients with severe falciparum malaria. We suggest crystalloid administration of 2-3 mL/kg per hour during the first 24 hours without bolus therapy, unless the patient is hypotensive.
URI: http://repository.li.mahidol.ac.th/dspace/handle/123456789/49642
metadata.dc.identifier.url: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85077349343&origin=inward
ISSN: 15376613
Appears in Collections:Scopus 2020

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