Poster Discussion Abstracts
Aims & Objectives:
To compare the outcome of fluid resuscitation with 20% albumin (Group A) versus 5% albumin (Group B) in severe dengue.
Prospective observational study from March 2016-March 2017. Children (1 month-16 years) with diagnosis of severe dengue admitted to pediatric intensive care unit (PICU) were recruited for the study. In addition to standard therapy as per WHO guidelines, patients received Group A-20%A (March 2016 – August2016) or Group B-5%A(Sep 2016- March 2017).Clinical & laboratory variables were recorded. Primary outcome was lactate clearance and the secondary outcome variables were mortality and morbidity- length of PICU & hospital stay, duration of mechanical ventilation (MV) and fluid overload.
A total of 76 children of which 34 in Group A and 42 in Group B.Baseline characteristics were comparable among the groups. The median lactate clearance(%) in Group A group was 40.62 %(IQR 28.57, 60.53) and group B was 16.25%(IQR 4.7,37.8) (p 0.048).The mean hospital stay was 145.9 ± 70.9 vs 214.1 ± 147.5hours (p-0.016), the mean PICU stay was 95.47 ± 33.83 vs 130.41 ± 85 hours(p-0.027), the mean duration of MV was 79 ± 16.6vs 161.37 ± 10.6 hours (p-0.045) among Group A and Group B respectively. No statistical difference in the fluid overload in both the groups at 24, 48, 72 hours. 2 children in Group B and 1 in Group A died.
Children receiving 20%A had better lactate clearance, lesser duration of MV, duration of PICU and hospital stay. Lactate clearance being a viable surrogate marker of resuscitation adequacy 20%A is superior to 5%A in severe dengue cases in our study.