W D Dilshan Priyankara, D G N Samarutilake, Sameera Viswakula, E M Manoj, Ananda Wijewickrama, Nilanka Perera, J K P Wanigasuriya
{"title":"登革出血热液体复苏期间静脉乳酸和血细胞比容变化的比较。","authors":"W D Dilshan Priyankara, D G N Samarutilake, Sameera Viswakula, E M Manoj, Ananda Wijewickrama, Nilanka Perera, J K P Wanigasuriya","doi":"10.1093/trstmh/trad050","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Judicious fluid resuscitation and stringent monitoring of clinical parameters improve the outcome of dengue haemorrhagic fever (DHF). The usefulness of serum lactate to monitor adequate fluid therapy has not been adequately explored.</p><p><strong>Methods: </strong>An observational study was conducted in Sri Lanka, recruiting 162 DHF patients within 12 h of diagnosis of the critical phase. Venous lactate level was measured at each time of performing haematocrit (HCT), using a prevalidated handheld lactate analyser.</p><p><strong>Results: </strong>The median venous lactate level was 1.3 (range 0.3-6) mmol/L in the study population and 154 (95.2%) patients had median lactate levels of <2 mmol/L. The HCT values in the study participants ranged from 28 to 62, with a median value of 43. There was no statistically significant correlation between the lactate and HCT values obtained at the same time. A significant reduction in venous lactate was not observed following the administration of fluid boluses. The expected reduction in HCT was seen following the administration of dextran and crystalloid/dextran combination. The maximum recorded lactate level positively correlated with the duration of hospital stay.</p><p><strong>Conclusions: </strong>This study concludes that venous lactate is not an appropriate parameter with which to monitor the response to fluid therapy in uncomplicated DHF.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A comparison of changes in venous lactate and haematocrit during fluid resuscitation of dengue haemorrhagic fever.\",\"authors\":\"W D Dilshan Priyankara, D G N Samarutilake, Sameera Viswakula, E M Manoj, Ananda Wijewickrama, Nilanka Perera, J K P Wanigasuriya\",\"doi\":\"10.1093/trstmh/trad050\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Judicious fluid resuscitation and stringent monitoring of clinical parameters improve the outcome of dengue haemorrhagic fever (DHF). The usefulness of serum lactate to monitor adequate fluid therapy has not been adequately explored.</p><p><strong>Methods: </strong>An observational study was conducted in Sri Lanka, recruiting 162 DHF patients within 12 h of diagnosis of the critical phase. Venous lactate level was measured at each time of performing haematocrit (HCT), using a prevalidated handheld lactate analyser.</p><p><strong>Results: </strong>The median venous lactate level was 1.3 (range 0.3-6) mmol/L in the study population and 154 (95.2%) patients had median lactate levels of <2 mmol/L. The HCT values in the study participants ranged from 28 to 62, with a median value of 43. There was no statistically significant correlation between the lactate and HCT values obtained at the same time. A significant reduction in venous lactate was not observed following the administration of fluid boluses. The expected reduction in HCT was seen following the administration of dextran and crystalloid/dextran combination. The maximum recorded lactate level positively correlated with the duration of hospital stay.</p><p><strong>Conclusions: </strong>This study concludes that venous lactate is not an appropriate parameter with which to monitor the response to fluid therapy in uncomplicated DHF.</p>\",\"PeriodicalId\":23218,\"journal\":{\"name\":\"Transactions of The Royal Society of Tropical Medicine and Hygiene\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-01-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transactions of The Royal Society of Tropical Medicine and Hygiene\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/trstmh/trad050\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transactions of The Royal Society of Tropical Medicine and Hygiene","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/trstmh/trad050","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
A comparison of changes in venous lactate and haematocrit during fluid resuscitation of dengue haemorrhagic fever.
Background: Judicious fluid resuscitation and stringent monitoring of clinical parameters improve the outcome of dengue haemorrhagic fever (DHF). The usefulness of serum lactate to monitor adequate fluid therapy has not been adequately explored.
Methods: An observational study was conducted in Sri Lanka, recruiting 162 DHF patients within 12 h of diagnosis of the critical phase. Venous lactate level was measured at each time of performing haematocrit (HCT), using a prevalidated handheld lactate analyser.
Results: The median venous lactate level was 1.3 (range 0.3-6) mmol/L in the study population and 154 (95.2%) patients had median lactate levels of <2 mmol/L. The HCT values in the study participants ranged from 28 to 62, with a median value of 43. There was no statistically significant correlation between the lactate and HCT values obtained at the same time. A significant reduction in venous lactate was not observed following the administration of fluid boluses. The expected reduction in HCT was seen following the administration of dextran and crystalloid/dextran combination. The maximum recorded lactate level positively correlated with the duration of hospital stay.
Conclusions: This study concludes that venous lactate is not an appropriate parameter with which to monitor the response to fluid therapy in uncomplicated DHF.
期刊介绍:
Transactions of the Royal Society of Tropical Medicine and Hygiene publishes authoritative and impactful original, peer-reviewed articles and reviews on all aspects of tropical medicine.