Your browser doesn't support javascript.
loading
Intravenous fluid therapy in hospitalized adult dengue patients without shock: Impact on subsequent severe dengue and potential adverse effects.
Xu, Baihui; Tewari, Pranav; Thein, Tun Linn; Sin, Leo Yee; Lye, David Chien Boon; Chia, Po Ying; Lim, Jue Tao.
Afiliación
  • Xu B; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, Singapore.
  • Tewari P; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, Singapore.
  • Thein TL; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore City, Singapore.
  • Sin LY; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, Singapore.
  • Lye DCB; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore City, Singapore.
  • Chia PY; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore City, Singapore.
  • Lim JT; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
J Med Virol ; 96(6): e29726, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38828952
ABSTRACT
There is a lack of evidence on the optimal administration of intravenous (IV) fluids in hospitalized adult dengue patients without compensated and hypotensive shock. This study utilized a well-established cohort of dengue patients to compare risks of progressing to severe dengue (SD) over time for patients who were administered IV fluid versus others who were not. We included adult patients (n = 4781) who were hospitalized for dengue infection from 2005 to 2008. Cases were patients who developed SD (n = 689) and controls were patients who did not up until discharge (n = 4092). We estimated the hazard ratios (HRs) and risk of SD over time between groups administered different volumes of IV fluids versus the no IV fluid comparison group using Cox models with time-dependent covariates. The doubly-robust estimation approach was used to control for the propensity of fluid administration given clinical characteristics of patients. Subgroup analyses by age, sex, and dengue warning signs before IV fluid administration were conducted. High (>2000 mL/day) IV fluids volume was associated with a higher risk of development of SD for those who had warning signs (HR 1.77 [1.05-2.97], p 0.0713) and for those below 55 years old (HR 1.53 [1.04-2.25], p 0.0713). Low (<1000 mL/day) IV fluids volume was protective against SD for patients without warning signs (HR 0.757 [0.578-0.990], p 0.0883), no lethargy (HR 0.770 [0.600-0.998], p 0.0847), and females (HR 0.711 [0.516-0.980], p 0.0804). Over the course of hospitalization, there were no significant differences in IV fluid administration and SD risk in most subgroups, except in those who experienced lethargy and were administered IV fluid volume or quantity. Administering high volumes of IV fluids may be associated with an increased risk of SD during hospitalization for adult dengue patients without shock. Judicious use of IV fluids as supportive therapy is warranted.
Asunto(s)
Palabras clave

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Dengue Grave / Administración Intravenosa / Fluidoterapia / Hospitalización Idioma: En Revista: J Med Virol Año: 2024 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Dengue Grave / Administración Intravenosa / Fluidoterapia / Hospitalización Idioma: En Revista: J Med Virol Año: 2024 Tipo del documento: Article