A comparison of changes in venous lactate and haematocrit during fluid resuscitation of dengue haemorrhagic fever

Author:

Priyankara W D Dilshan1,Samarutilake D G N2,Viswakula Sameera3,Manoj E M1,Wijewickrama Ananda4,Perera Nilanka5ORCID,Wanigasuriya J K P5

Affiliation:

1. Medical Intensive Care Unit, National Hospital of Sri Lanka , Colombo , Sri Lanka

2. Ministry of Health , Colombo , Sri Lanka

3. Department of Statistics, University of Colombo , Colombo , Sri Lanka

4. National Institute of Infectious Diseases , Angoda , Sri Lanka

5. Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura , Colombo , Sri Lanka

Abstract

ABSTRACT 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.

Funder

University of Sri Jayewardenepura

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine,Parasitology

Reference20 articles.

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2. Dengue and severe Dengue;World Health Organization

3. The global distribution and burden of dengue;Bhatt;Nature,2013

4. Evolution of dengue in Sri Lanka-changes in the virus, vector, and climate;Sirisena;Int J Infect Dis,2014

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