Displaying publications 1 - 20 of 46 in total

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  1. Rosenberger KD, Lum L, Alexander N, Junghanss T, Wills B, Jaenisch T, et al.
    Trop Med Int Health, 2016 Mar;21(3):445-53.
    PMID: 26752720 DOI: 10.1111/tmi.12666
    OBJECTIVE: Clinical management of dengue relies on careful monitoring of fluid balance combined with judicious intravenous (IV) fluid therapy. However, in patients with significant vascular leakage, IV fluids may aggravate serosal fluid accumulation and result in respiratory distress.
    METHODS: Trained physicians followed suspected dengue cases prospectively at seven hospitals across Asia and Latin America, using a comprehensive case report form that included daily clinical assessment and detailed documentation of parenteral fluid therapy. Applying Cox regression, we evaluated risk factors for the development of shock or respiratory distress with fluid accumulation.
    RESULTS: Most confirmed dengue patients (1524/1734, 88%) never experienced dengue shock syndrome (DSS). Among those with DSS, 176/210 (84%) had fluid accumulation, and in the majority (83%), this was detectable clinically. Among all cases with clinically detectable fluid accumulation, 179/447 (40%) were diagnosed with shock or respiratory distress. The risk for respiratory distress with fluid accumulation increased significantly as the infused volume over the preceding 24 h increased (hazard ratio 1.18 per 10 ml/kg increase; P < 0.001). Longer duration of IV therapy, use of a fluid bolus in the preceding 24 h, female gender and poor nutrition also constituted independent risk factors.
    CONCLUSIONS: Shock and respiratory distress are relatively rare manifestations of dengue, but some evidence of fluid accumulation is seen in around 50% of cases. IV fluids play a crucial role in management, but they must be administered with caution. Clinically and/or radiologically detectable fluid accumulations have potential as intermediate severity endpoints for therapeutic intervention trials and/or pathogenesis studies.
    KEYWORDS: IV fluid therapy; clinical spectrum; dengue; espectro clínico; fluidothérapie IV; fuga vascular; fuite vasculaire; prospectif; prospective; prospectivo; spectre clinique; terapia IV de fluidos; vascular leakage
    Matched MeSH terms: Fluid Therapy*
  2. Prabhu SP, Nileshwar A, Krishna HM, Prabhu M
    Niger J Clin Pract, 2021 Nov;24(11):1682-1688.
    PMID: 34782509 DOI: 10.4103/njcp.njcp_30_20
    Background: Stroke volume variation (SVV) is a dynamic indicator of preload, which is a determinant of cardiac output. Aims: Aim of this study was to evaluate the relationship between changes in SVV and cardiac index (CI) in patients with normal left ventricular function undergoing major open abdominal surgery.

    Patients and Methods: Patients undergoing major open abdominal surgery were monitored continuously with FloTrac® to measure SVV and CI along with standard monitoring. Both SVV and CI were noted at baseline and every 10 min thereafter till the end of surgery and were observed for concurrence between the measurements.

    Results: 1800 pairs of measurement of SVV and CI were obtained from 60 patients. Mean SVV and CI (of all patients) measured at different time points of measurement showed that as SVV increased with time, the CI dropped correspondingly. When individual readings of CI and SVV were plotted against each other, the scatter was found to be wide, reiterating the lack of agreement between the two parameters (R2 = 0.035). SVV >13% suggesting hypovolemia was found at 207 time points. Of these, 175 had a CI >2.5 L/min/m2 and only 32 patients had a CI <2.5 L/min/m2.

    Conclusion: SVV, a dynamic index of fluid responsiveness can be used to monitor patients expected to have large fluid shifts during major abdominal surgery. It is very specific and has a high negative predictive value. When SVV increases, CI is usually maintained. Since many factors affect SVV and CI, any increase in SVV >13%, must be correlated with other parameters before administration of the fluid challenge.

    Matched MeSH terms: Fluid Therapy*
  3. Tan PC, Norazilah MJ, Omar SZ
    Obstet Gynecol, 2013 Feb;121(2 Pt 1):291-298.
    PMID: 23232754 DOI: 10.1097/AOG.0b013e31827c5e99
    OBJECTIVE: To compare 5% dextrose-0.9% saline against 0.9% saline solution in the intravenous rehydration of hyperemesis gravidarum.

    METHODS: Women at their first hospitalization for hyperemesis gravidarum were enrolled on admission to the ward and randomly assigned to receive either 5% dextrose-0.9% saline or 0.9% saline by intravenous infusion at a rate 125 mL/h over 24 hours in a double-blind trial. All participants also received thiamine and an antiemetic intravenously. Oral intake was allowed as tolerated. Primary outcomes were resolution of ketonuria and well-being (by 10-point visual numerical rating scale) at 24 hours. Nausea visual numerical rating scale scores were obtained every 8 hours for 24 hours.

    RESULTS: Persistent ketonuria rates after the 24-hour study period were 10 of 101 (9.9%) compared with 11 of 101 (10.9%) (P>.99; relative risk 0.9, 95% confidence interval 0.4-2.2) and median (interquartile range) well-being scores at 24 hours were 9 (8-10) compared with 9 (8-9.5) (P=.73) in the 5% dextrose-0.9% saline and 0.9% saline arms, respectively. Repeated measures analysis of variance of the nausea visual numerical rating scale score as assessed every 8 hours during the 24-hour study period showed a significant difference in favor of the 5% dextrose-0.9% saline arm (P=.046) with the superiority apparent at 8 and 16 hours, but the advantage had dissipated by 24 hours. Secondary outcomes of vomiting, resolution of hyponatremia, hypochloremia and hypokalemia, length of hospitalization, duration of intravenous antiemetic, and rehydration were not different.

    CONCLUSIONS: Intravenous rehydration with 5% dextrose-0.9% saline or 0.9% saline solution in women hospitalized for hyperemesis gravidarum produced similar outcomes.

    CLINICAL TRIAL REGISTRATION: ISRCTN Register, www.controlled-trials.com/isrctn, ISRCTN65014409.

    LEVEL OF EVIDENCE: I.

    Matched MeSH terms: Fluid Therapy*
  4. Saat M, Singh R, Sirisinghe RG, Nawawi M
    J Physiol Anthropol Appl Human Sci, 2002 Mar;21(2):93-104.
    PMID: 12056182
    This is to cross-over study to assess the effectiveness of fresh young coconut water (CW), and carbohydrate-electrolyte beverage (CEB) compared with plain water (PW) for whole body rehydration and blood volume (BV) restoration during a 2 h rehydration period following exercise-induced dehydration. Eight healthy male volunteers (mean age and VO2max of 22.4 +/- 3.3 years and 45.8 +/- 1.5 ml min kg-1 respectively) exercised at 60% of VO2max in the heat (31.1 +/- 0.03 degrees C, 51.4 +/- 0.1% rh) until 2.78 +/- 0.06% (1.6 +/- 0.1 kg) of their body weight (BW) was lost. After exercise, the subjects sat for 2 h in a thermoneutral environment (22.5 +/- 0.1 degrees C; 67.0 +/- 1.0% rh) and drank a volume of PW, CW and CEB on different occasions representing 120% of the fluid loss. A blood and urine sample, and the body weight of each subject was taken before and after exercise and at 30 min intervals throughout a rehydration period. Each subject remained fasted throughout rehydration. Each fluid was consumed in three portions in separate trials representing 50% (781 +/- 47 ml), 40% (625 +/- 33 ml) and 30% (469 +/- 28 ml) of the 120% fluid loss at 0, 30 and 60 min of the 2 h rehydration period, respectively. The drinks given were randomised. In all the trials the subjects were somewhat hypohydrated (range 0.08-0.18 kg BW below euhydrated BW; p > 0.05) after a 2 h rehydration period since additional water and BW were lost as a result of urine formation, respiration, sweat and metabolism. The percent of body weight loss that was regained (used as index of percent rehydration) during CW, PW, and CEB trials was 75 +/- 5%, 73 +/- 5% and 80 +/- 4% respectively, but was not statistically different between trials. The rehydration index, which provided an indication of how much of what was actually ingested was used for body weight restoration, was again not different statistically between trials (1.56 +/- 0.14, 1.36 +/- 0.13 and 1.71 +/- 0.21 for CW, CEB and PW respectively). Although BV restoration was better with CW, it was not statistically different from CEB and PW. Cumulative urine output was similar in all trials. There were no difference at any time in serum Na+ and Cl-, serum osmolality, and net fluid balance between the three trials. Urine osmolality decreased after 1 h during the rehydration period and it was lowest in the PW trial. Plasma glucose concentrations were significantly higher compared with PW ingestion when CW and CEB were ingested during the rehydration period. CW was significantly sweeter, caused less nausea, fullness and no stomach upset and was also easier to consume in a larger amount compared with CEB and PW ingestion. In conclusion, ingestion of fresh young coconut water, a natural refreshing beverage, could be used for whole body rehydration after exercise.
    Matched MeSH terms: Fluid Therapy*
  5. Shaw DD, Jacobsen CA, Konare KF, Isa AR
    Med J Malaysia, 1990 Dec;45(4):304-9.
    PMID: 2152051
    A community based study was conducted on the understanding and knowledge of childhood diarrhoea and use of oral rehydration therapy (ORT), in four selected villages in Tumpat District, Kelantan. The calculated annual incidence of diarrhoeal disease in children aged 0 to four years in all study villages was 1.38 episodes for each child. The main care-givers of children aged 0 to four years were interviewed and asked to demonstrate how to mix a standard ORS (oral rehydration solution) sachet if they had previously used ORT. Forty percent of care-givers had heard of the locally available ORT and 30% had actually used ORT. Of those who had heard of or used ORT, 10% had good knowledge of what it was and what it was used for, 51% had some knowledge and 39% had either no knowledge or inaccurate knowledge. Of care-givers who had previously used ORT only 20.5% demonstrated the correct volume of water to add to one sachet of ORT, but 82% would discard an unused solution within 24 hours. Significantly more literate women had used ORT than those not literate (p = 0.002). Mothers, particularly those literate, are the primary target group for ORT intervention strategies. Components of health education should include advice on what ORS is, what it is used for, and how to correctly mix a standard sachet.
    Matched MeSH terms: Fluid Therapy*
  6. Tan PC, Norazilah MJ, Omar SZ
    Obstet Gynecol, 2013 Jun;121(6):1360.
    PMID: 23812475 DOI: 10.1097/AOG.0b013e31829395ef
    Matched MeSH terms: Fluid Therapy*
  7. Agduma AR, Sese MD
    Trop Life Sci Res, 2016 Aug;27(2):37-52.
    PMID: 27688850 DOI: 10.21315/tlsr2016.27.2.4
    The biochemical changes in two Selaginella species namely, S. tamariscina (Beauv.) Spring and S. plana (Desv. ex Poir.) Heiron., as induced by desiccation and subsequent rehydration were explored. Plants were allowed to dehydrate naturally by withholding irrigation until shoot's relative water content (RWC) reached <10%. After which, dehydrated plants were watered until fully rehydrated states were obtained which was about 90% RWC or more. Desiccation-tolerance characteristics were observed in S. tamariscina while desiccation-sensitivity features were seen in S. plana. Membrane integrity was maintained in S. tamariscina but not in S. plana as evidenced in the relative electrolyte leakage measurements during desiccation phase and the subsequent rehydration stage. Pigment analyses revealed conservation of some chlorophylls and carotenoids during desiccation and reaching control levels following rehydration in S. tamariscina. Very low pigment contents were found in S. plana during desiccation phase and the pigments were not recovered during rehydration attempt. Meanwhile, compatible solute determination showed rise in total sugar and proline contents of desiccated S. tamariscina only, indicating presence of biochemical protection machineries in this species and absence of such in S. plana during dehydrating conditions. These data indicate that one key element for desiccation-tolerance in lower vascular plants is the ability to protect tissues from severe damages caused by intense desiccation.
    Matched MeSH terms: Fluid Therapy
  8. Naing CM, Win DK
    Trans R Soc Trop Med Hyg, 2010 May;104(5):311-2.
    PMID: 20206954 DOI: 10.1016/j.trstmh.2010.02.001
    Permanent neurological impairment or death arising from hospital-acquired hyponatremia in both children and adults is well documented. The choice of intravenous fluids for fluid resuscitation in critically ill patients is a top priority in evidence-based medicine. The question of whether colloids in comparison to crystalloids can improve mortality in such cases remains to be answered. Well powered, randomized clinical trials addressing the comparative efficacy of different types of intravenous fluids is a high priority as is the ethical justification for such trials. The understanding of the pathophysiological process serves important information on clinical practice.
    Matched MeSH terms: Fluid Therapy/adverse effects; Fluid Therapy/methods*
  9. Yunos NM, Bellomo R, Taylor DM, Judkins S, Kerr F, Sutcliffe H, et al.
    Emerg Med Australas, 2017 Dec;29(6):643-649.
    PMID: 28597505 DOI: 10.1111/1742-6723.12821
    OBJECTIVE: Patients commonly receive i.v. fluids in the ED. It is still unclear whether the choice of i.v. fluids in this setting influences renal or patient outcomes. We aimed to assess the effects of restricting i.v. chloride administration in the ED on the incidence of acute kidney injury (AKI).

    METHODS: We conducted a before-and-after trial with 5008 consecutive ED-treated hospital admissions in the control period and 5146 consecutive admissions in the intervention period. During the control period (18 February 2008 to 17 August 2008), patients received standard i.v. fluids. During the intervention period (18 February 2009 to 17 August 2009), we restricted all chloride-rich fluids. We used the Kidney Disease: Improving Global Outcomes (KDIGO) staging to define AKI.

    RESULTS: Stage 3 of KDIGO-defined AKI decreased from 54 (1.1%; 95% confidence interval [CI] 0.8-1.4) to 30 (0.6%; 95% CI 0.4-0.8) (P = 0.006). The rate of renal replacement therapy did not change, from 13 (0.3%; 95% CI 0.2-0.4) to 8 (0.2%; 95% CI 0.1-0.3) (P = 0.25). After adjustment for relevant covariates, liberal chloride therapy remained associated with a greater risk of KDIGO stage 3 (hazard ratio 1.82; 95% CI 1.13-2.95; P = 0.01). On sensitivity assessment after removing repeat admissions, KDIGO stage 3 remained significantly lower in the intervention period compared with the control period (P = 0.01).

    CONCLUSION: In a before-and-after trial, a chloride-restrictive strategy in an ED was associated with a significant decrease in the incidence of stage 3 of KDIGO-defined AKI.

    Matched MeSH terms: Fluid Therapy/methods*; Fluid Therapy/standards*
  10. Shaik Farid AW, Mohd Hashairi F, Nik Hisamuddin NA, Chew KS, Rashidi A
    Med J Malaysia, 2013 Dec;68(6):465-8.
    PMID: 24632914 MyJurnal
    According to the class of hypovolaemic shock, a blood loss less than 750 ml is not associated with the physiological changes. As a result it may cause a delay in fluid resuscitation. We postulate inferior vena cava (IVC) diameter reduction in inspiration and expiration may resemble the significant volume of blood loss in a healthy adult. We conducted a study to examine the changes of the IVC diameter pre and post blood donation.The inferior vena cava diameter during inspiration (IVCi) and expiration (IVCe) were measured using ultrasound (GE HEALTH) in supine position before and after blood donation of 450 ml. Paired t-test and Wilcoxin rank test were used to analyse the data. Forty two blood donors enrolled during the study period. The mean age of blood donors was 32.3 +/- 8.9 and mainly male blood donors. The mean IVCe of pre and post blood donation was 18.5 +/- 6.2 mm (95%CI 18.23, 18.74) and 16.6 +/- 6.6 mm (95%CI 16.35, 16.76) respectively. Meanwhile, the mean IVCi of pre and post blood donation was 17.1 +/- 8.6 mm (95%CI 16.89,17.30) and 15.6 +/- 6.6 mm (95%CI 15.43,15.81) respectively. The mean difference of IVCe pre and post blood donation was 1.9 +/- 0.5 mm (95%CI 1.75, 2.13) (p<0.001). In contrast, the mean difference of IVCi pre and post blood donation was 1.5 +/- 0.5 mm (95%CI 1.34, 1.68) (p<0.001). As a conclusion, the measurement of IVC diameter by ultrasound can predict the volume of blood loss in simulated type 1 hypovolaemia patient.
    Matched MeSH terms: Fluid Therapy
  11. Ramanathan M, Teng TL
    Med J Malaysia, 1991 Sep;46(3):283-6.
    PMID: 1839926
    We present a young lady who satisfied the criteria for the diagnosis of toxic-shock syndrome (TSS). The differential diagnoses of TSS in the local setting are outlined. The pertinent clinical features of TSS and its increasing association with nonmenstruating females are highlighted.
    Matched MeSH terms: Fluid Therapy
  12. Azrina Md Ralib, Mohd Basri Mat Nor
    MyJurnal
    Urine output provides a rapid estimate for kidney function, and its use has been incorporated in the diagnosis of acute kidney injury. However, not many studies had validated its use compared to the plasma creatinine. It has been showed that the ideal urine output threshold for prediction of death or the need for dialysis was 0.3 ml/kg/h. We aim to assess this threshold in our local ICU population.
    Matched MeSH terms: Fluid Therapy
  13. Sue Shan, L., Sulaiman, R., Sanny, M., Nur Hanani, Z.A.
    MyJurnal
    The aim of this study was to evaluate the effect of barrel temperature and flour types on the residence time and physical properties of various flour extrudates. Corn flour, rice flour, corn flour with potato starch (30% w/w, d.b), and rice flour with potato starch (30%w/w, d.b) were extruded at screw speed of 75rpm, feed moisture at 25% (w/w, w.b.), barrel temperature ranging from 80°C to 140°C and die size of 1.88mm. The extrudates were dried at 50°C overnight and further analysed. Results showed that an increase in extruder barrel temperature decreased the residence time of the flours in the extruder (from 4.11-11.32min to 2.24-6.76min), but increased the expansion ratio, rehydration ratio, water absorption index, water solubility index and b value of the extrudate (p≤0.05). The extrudates had the mean residence time and physical properties of rice flour
    Matched MeSH terms: Fluid Therapy
  14. Azimah Ahmad, Normah Jusoh, Ruaibah Yazani Tengah
    MyJurnal
    The purpose of rehydration is to replace fluid and electrolyte losses. Carbohydrates and sodium are the main nutrient sources for rehydration. The presence of protein aids the rehydration process and thereby promoting muscle synthesis. Zea mays had been identified as one of the potential food sources that could be an alternative recovery beverage. The aim of this study was to assess the potential of Zea mays (ZM) juice as an alternative rehydration beverage. A total of 15 male participants were involved in this study. They were required to cycle to 70-80% of their age predicted maximum heart rate until they were dehydrated (1.8-2% body weight loss). Then they were given either ZM juice or CE drink in an amount representing 150% of their initial body weight loss. After 4-hours of rest with no other food allowed, their USG and percentage of fluid retention were calculated. Results showed that ZM juice had better retention and demonstrated well hydrated USG readings compared to CE drink. Therefore, ZM juice has the potential to be an alternative rehydration beverage.
    Matched MeSH terms: Fluid Therapy
  15. Ismail I, Singh R, Sirisinghe RG
    PMID: 17883020
    This crossover study assessed the effectiveness of plain water (PW), sports drink (SD), fresh young coconut water (CW) and sodium-enriched fresh young coconut water (SCW) on whole body rehydration (R) and plasma volume (PV) restoration after exercise-induced dehydration. Ten healthy male subjects ran at 65% of VO2max in an environmental temperature of 32.06 +/- 0.02 degree C with a relative humidity (rh) of 53.32 +/- 0.17% for 90 minutes to lose 3% body weight (BW). During the 2-hour rehydration period, subjects drank, in randomized order, PW, SD, CW or SCW equivalent to 120% of BW lost in three boluses representing 50, 40 and 30% of the fluid lost at 0, 30, and 60 minutes, respectively. In all trials subjects were still somewhat dehydrated even after the 2-hour rehydration period. Indexes of percent rehydration with PW, SD, CW and SCW were 58 +/- 2, 68 +/- 2, 65+/- 2 and 69 +/- 1%, respectively, with significantly better rehydration with SD and SCW. The rehydration indexes for SD and SCW were significantly lower than PW (p < 0.01). PV was restored to euhydration levels after 2 hours of rehydration with SD, CW and SCW but not with PW. The plasma glucose concentration were significantly higher when SD, CW and SCW were ingested. SCW was similar in sweetness to CW and SD but caused less nausea and stomach upset compared to SD and PW. In conclusion, ingesting SCW was as good as ingesting a commercial sports drink for whole body rehydration after exercise-induced dehydration but with better fluid tolerance.
    Matched MeSH terms: Fluid Therapy/methods*
  16. Singh R, Brouns F, Kovacs E
    PMID: 12236441
    The effects of 7.6% carbohydrate-electrolyte solution (CES) and placebos (P) on rehydration (R) after exercise-induced dehydration and on a subsequent time-trial (TT) of cycling performance were studied. Thirteen male subjects exercised in a thermally-controlled environment (28 degrees C, 63% RH) until 3% of their body weight was lost. After exercise, the subjects moved to a neutral environment (22 degrees C) and rested for 30 minutes prior to a 2-hour R period. During R, subjects were fed CES or P to a maximum volume of 120% of previous body mass loss at 0, 30, and 60 minutes, in bolus-doses of 50%, 40% and 30% respectively. After R, subjects performed a 1-hour TT with no further fluid intake. % R with CES was significantly higher than with P (70 +/- 3% vs 60 +/- 5%; p < 0.01). During the TT, blood glucose dropped in the CES group but not in the P group. It was found that, despite a more effective R with CES, the performance results did not differ between groups (65.1 +/- 2.2 minutes and 65.2 +/- 2.3 minutes for CES and P respectively). It is suggested that an insulin-mediated rebound effect on CHO metabolism during TT, in which no further CHO was supplied, nullified the benefits of rehydration.
    Matched MeSH terms: Fluid Therapy*
  17. Boo NY, Lee HT
    J Paediatr Child Health, 2002 Apr;38(2):151-5.
    PMID: 12030996
    OBJECTIVE: To compare the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy.

    METHODS: A randomized controlled study was carried out in the neonatal intensive care unit (NICU) of Hospital Universiti Kebangsaan Malaysia over a 12-month period. Fifty-four healthy term infants with severe hyperbilirubinemia were randomized to receive either solely enteral feeds (n = 27) or both enteral and intravenous (n = 27) fluid during phototherapy.

    RESULTS: There were no significant differences in the mean birthweight, mean gestational age, ethnic distribution, gender distribution, modes of delivery and types of feeding between the two groups. Similarly, there was no significant difference in the mean indirect serum bilirubin (iSB) level at the time of admission to the NICU between the enteral (359 +/- 69 micromol/L [mean +/- SD]) and intravenous group (372 +/- 59 micromol/L; P = 0.4). The mean rates of decrease in iSB during the first 4 h of phototherapy were also not significantly different between the enteral group (10.4 +/- 4.9 micromol/L per h) and intravenous group (11.2 +/- 7.4 micromol/L per h; P = 0.6). There was no significant difference in the proportion of infants requiring exchange transfusion (P = 0.3) nor in the median duration of hospitalization (P = 0.7) between the two groups. No infant developed vomiting or abdominal distension during the study period.

    CONCLUSION: Severely jaundiced healthy term infants had similar rates of decrease in iSB levels during the first 4 h of intensive phototherapy, irrespective of whether they received oral or intravenous fluid supplementation. However, using the oral route avoided the need for intravenous cannulae and their attendant complications.

    Matched MeSH terms: Fluid Therapy/methods*
  18. Iyngkaran N, Yadav M
    Med J Malaysia, 1995 Jun;50(2):141-4.
    PMID: 7565183
    The relative efficacy and incidence of hypernatremia of a rice starch based low sodium (sodium of 60 mmol/L) oral electrolyte solution was compared to the standard WHO oral rehydration solution (ORS; sodium 90 mmol/L) in 60 infants with non choleragenic acute diarrhoea. Both solutions were found to be equally effective in correcting dehydration as determined by the respective post hydration weight gain which was 150 +/- 175 gms in the rice starch low sodium ORS group and 164 +/- 125 gms in the standard WHO ORS group. However, the mean frequency of stools was greater and the duration of stay longer in the WHO ORS group compared to the rice starch low sodium group. There were 5 cases of hypernatremia in the WHO ORS group as opposed to only one in the rice starch low sodium ORS group. The present study shows that a rice starch low sodium ORS was as effective as the standard WHO ORS and had a lower incidence of hypernatremia in the fluid and electrolyte management of infants with non choleragenic diarrhoea.
    Matched MeSH terms: Fluid Therapy*
  19. Iyngkaran N, Yadav M
    J Trop Pediatr, 1998 08;44(4):199-203.
    PMID: 9718904 DOI: 10.1093/tropej/44.4.199
    Rice-starch based oral rehydration solution (ORS) has been shown to be a suitable alternative to glucose-based ORS in the treatment of both choleragenic and non-choleragenic dehydration in older infants and children. However, in young infants, the wider use of rice-starch ORS has been impeded because of theoretical concern about the poor digestibility of starch. The present study was conducted to evaluate the safety and efficacy of rice-starch ORS in the rehydration of acute diarrhoeal dehydration in infants below 6 months of age. Sixty-three infants with clinical features of acute gastroenteritis were randomly allocated to two groups. Group A, comprising 31 infants, received a rice-starch ORS and group B, comprising 32 infants, received a glucose-based ORS. The response to treatment was monitored by weight gain, stool frequency, and decrease in vomiting. The mean weight gain in moderately dehydrated and mildly dehydrated infants in both groups A and B were closely similar at 12, 24, and 48 h after treatment with the respective ORS solution. The infants without dehydration receiving rice-starch ORS had significantly greater weight gain at 12 h compared to those receiving glucose ORS. However, this difference was not observed at 24 and 48 h. The results of this study show that rice-starch ORS is as safe and efficacious as glucose-based ORS in young infants.
    Matched MeSH terms: Fluid Therapy/methods
  20. Nasir NH, Mohamad M, Lum LCS, Ng CJ
    PLoS One, 2017;12(10):e0183544.
    PMID: 28977019 DOI: 10.1371/journal.pone.0183544
    INTRODUCTION: Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever.
    OBJECTIVE: To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting.
    METHODS: This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets < 150 x 109/L). Both groups received a dengue home care card. The intervention group received the fluid chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake.
    FINDINGS: Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance.
    CONCLUSION: This is a feasible and acceptable study to perform in a primary care setting. The fluid chart is a simple, inexpensive tool that may reduce hospitalization and intravenous fluid requirement in suspected dengue patients. A randomized controlled trial with larger sample size is needed to determine this conclusively.
    TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) Registry ISRCTN25394628 http://www.isrctn.com/ISRCTN25394628.
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Fluid Therapy*
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