Abstract:
OBJECTIVE:To compare the efficacy of crystalloid (Normal saline) and colloid (polymer from degraded Gelatin in saline Haemaccel) intravenous fluid in restoration of circulating volume in children with septic shock. DESIGN:Prospective, randomized, open-label trial. SETTING:Pediatric Emergency and Intensive Care Unit of a tertiary care referral and teaching hospital. SUBJECTS AND INCLUSION CRITERIA: Sixty patients, between 1 month to 12 years of age, with septic shock, without clinical evidence of organ failure at admission or underlying immunodeficiency. INTERVENTION:Resuscitation with normal saline or polymer from degraded gelatin (Haemaccel) in the boluses rate of 20 mL/kg till hemodynamic stabilization or if central venous pressure (CVP) exceeded 10 mmHg (fluid requirement beyond 40 mL/kg guided by BP and CVP). METHODS:Hemodynamic parameters (heart rate, capillary filling time, pulse volume, and blood pressure) were recorded before and during resuscitation, and then 2 hourly for 12 hours. Central venous pressure line was placed within first hour, soon after starting fluids. Estimation of plasma volume and body water was done at the end of first hour of fluid resuscitation. OUTCOME MEASURES:Hemodynamic stabilization (heart rate, capillary refill time, systolic BP in normal range), plasma volume at the end of fluid resuscitation and incidence of organ dysfunction. RESULTS:31 patients were randomized to normal saline and 29 to gelatin polymer. Both the groups were similar with respect to age, gender, primary diagnosis, initial hemodynamic parameters and PRISM score. Pneumonia (n = 22; 36%), gut-associated sepsis (n = 13), and dengue hemorrhagic fever (n = 11) were the common primary diagnosis. Initial hemodynamic stabilization was achieved in all. The mean (SD plasma volume (saline--53.4 (2.0 mL/kg, gelatin polymer--53.2 (1.9 mL/kg), extracellular fluid volume, total body water and interstitial fluid volume at the end of first hour of resuscitation were similar. The requirement of inotropes, incidence of organ dysfunction and case fatality rate (Saline--29%, gelatin polymer--31%), were similar in two groups. CONCLUSION:Both normal saline and gelatin polymer solution were equally effective as resuscitation fluid with respect to restoration of plasma volume and hemodynamic stability. Normal saline upto 110 mL/kg, and gelatin polymer solution upto 70 mL/kg may be required in first hour for successful fluid resuscitation of septic shock in children.
journal_name
Indian Pediatrjournal_title
Indian pediatricsauthors
Upadhyay M,Singhi S,Murlidharan J,Kaur N,Majumdar Skeywords:
subject
Has Abstractpub_date
2005-03-01 00:00:00pages
223-31issue
3eissn
0019-6061issn
0974-7559journal_volume
42pub_type
杂志文章,随机对照试验abstract::A modified technique for umbilical artery catheterization was assessed in babies in whom conventional method failed or if the cord was dry. Success rate attained with the modified technique was 90% (19/21). This modified technique could provide an easier and faster method for successful umbilical arterial catheterizat...
journal_title:Indian pediatrics
pub_type: 信件
doi:10.1007/s13312-014-0477-x
更新日期:2014-08-01 00:00:00
abstract::Twenty five to thirty per cent of all patients admitted with head injuries to any large hospital are children. Head injuries in children differ in several ways from those seen in the adult population. A standard management protocol is used in a service hospital and CT and neurosurgical consultation/transfer is based o...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::Neural tube defects (NTD) comprise of a group of congenital malformations that include spina bifida, anencephaly and encephalocele. Reports have implicated zinc deficiency as one of the causative factors of NTDs. We compared the serum zinc level of 23 newborns having neural tube defects with 35 healthy controls by spe...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2006-09-01 00:00:00
abstract::There is a growing body of evidence over the last years suggesting continuous positive airway pressure (CPAP) ventilation being the first choice of ventilatory support in newborns with extremely low gestational age, and early rescue surfactant treatment being as effective as prophylactic therapy. The Intubation Surfac...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-015-0612-3
更新日期:2015-03-08 00:00:00
abstract:OBJECTIVE:To compare the short-term efficacy of room air versus 100% oxygen for resuscitation of asphyxic newborns at birth. DESIGN:Multicentric quasi randomized controlled trial. SETTING:Teaching hospitals. INCLUSION CRITERIA:Asphyxiated babies weighing greater than 1000 grams, with heart rate less than 100 per min...
journal_title:Indian pediatrics
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVES:To evaluate whether zinc supplements prevent mortality and morbidity in breastfed low birth weight infants. METHODS:All randomized or qausi-randomized trials with individual or cluster allocation and using concurrent controls were included. Study population included LBW infants irrespective of gestational s...
journal_title:Indian pediatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s13312-011-0043-8
更新日期:2011-02-01 00:00:00
abstract::Idiopathic pulmonary hemosiderosis is conventionally treated with steroids, prolonged usage of which maybe deleterious and disease often recurs on tapering. We initiated hydroxy-chloroquine and azathioprine early in treatment along with steroids in seven children with idiopathic pulmonary hemosiderosis, and observed t...
journal_title:Indian pediatrics
pub_type: 信件
doi:
更新日期:2019-01-15 00:00:00
abstract:OBJECTIVE:In Karnataka state, perinatal mortality rate is almost equal to infant mortality rate. This preliminary study was conducted in two districts of Karnataka to study potential problems to start of perinatal death audit. METHODS:Hospitals providing maternal and child health care services, which met study inclusi...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2020-11-15 00:00:00
abstract::Seven cases of benign form of spinal muscular atrophy were studied to evaluate the importance of detecting hand tremors, muscle fasciculation, evertion of foot and ECG tremors to distinguish these cases from muscular dystrophy. Taken in combination, diagnosis of all the seven cases was possible without the need for ap...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:To assess the Vitamin A status of pregnant women in their third trimester using maternal serum retinol levels as the indicator; and (ii) To assess the impact of postpartum Vitamin A supplementation on the Vitamin A status of exclusively breastfed infants. DESIGN:Prospective randomized single blind controlled...
journal_title:Indian pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2000-11-01 00:00:00
abstract::Atypical celiac disease (ACD) presenting in childhood has rarely been documented from India. The present retrospective study analyzed features of atypical celiac disease over a 5-year period. Patients were diagnosed to have Celiac Disease (CD) as per the standard ESPGHAN criteria. The biochemical and hematological par...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:To improve the rates of first hour initiation of breastfeeding in neonates born through cesarean section from 0 to 80% over 3 months through a quality improvement (QI) process. DESIGN:Quality improvement study. SETTING:Labor Room-Operation Theatre of a tertiary care hospital. PARTICIPANTS:Stable newborns ≥...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2018-09-15 00:00:00
abstract::A 5 year old boy and a 10 year old girl presented with acute onset of psychotic disorder, which occurred one week after an upper respiratory infection. MRI images of brain were consistent with the diagnosis of acute disseminated encephalomyelitis (ADEM) in both cases. ADEM is one of the differential diagnoses to be co...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2008-12-01 00:00:00
abstract::Massive open online courses (MOOCs) are currently the buzz word in the field of e-learning. By definition, MOOCs are massive courses considering the number of participants enrolled across the globe per course, are open accessed, and are available online. MOOCs have evolved along the trajectory of correspondence course...
journal_title:Indian pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:2019-06-15 00:00:00
abstract:BACKGROUND:GM1 gangliosidosis is a disorder due to GLB1 gene mutation. CASE CHARACTERISTICS:A 4-yr-old boy with neuroregression and optic atrophy with periventricular hyperintensity on magnetic resonance imaging. OUTCOME:Beta galactosidase enzyme activity was low which was confirmed by GLB1 sequencing. MESSAGE:We hi...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-015-0593-2
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:High bilirubin level is toxic to developing brain and auditory system but the current debate surrounds the toxicity of bilirubin in healthy term infants. METHODS:Longitudinal observational study to find BERA abnormalities in term newborns with isolated hyperbilirubinemia of 20 mg/dL and more and to follow u...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-014-0346-7
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of artemether and quinine in the treatment of severe malaria in hospitalized children. STUDY DESIGN:Open randomized trial. SETTING:Pediatric ward of a tertiary care center. METHODS:All children admitted with clinical manifestations of severe malaria (as per WHO criteria) and asexual...
journal_title:Indian pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-10-01 00:00:00
abstract::Social, cultural and economic factors, beside medical causes, contribute to the high percentage of infant mortality in India. This study was carried out in 12 villages in the area of the Rural Health Training Centre, Naila, India; all villages were being regularly visited by paramedical staff and doctors. During 197...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Mediastinal pancreatic pseudocyst is a rare complication of pancreatitis. CASE CHARACTERISTICS:An 8-year-old boy with chest pain and shortness of breath. Computed tomography of chest showed a cystic mass in the mediastinum. The cyst aspirate revealed high amylase and lipase levels, suggestive of pancreatic ...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2018-03-15 00:00:00
abstract::Clinical needs for new antifungal agents have steadily increased with the rise and alteration in spectrum of invasive mycoses in children and neonates having AIDS, malignancies and undergoing immunosuppressive therapies. Several new options are now available for management of serious fungal infections. The aim of this...
journal_title:Indian pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:Comparison of the clinical efficacy of a transparent, DPI (transparent Rotahaler) with MDI and spacers in childhood asthma. DESIGN:Open, randomized, crossover trial. SETTINGS:Out patient clinic of a referral pediatric center. METHODS:Thirty (mean 6.1 +/-2.7 years) children with moderate persistent asthma w...
journal_title:Indian pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2001-01-01 00:00:00
abstract::Thirty six neonates with severe birth asphyxia (Apgar score less than or equal to 3 at 1 min), 32 with moderate birth asphyxia (Apgar score 4 to 6 at 1 min) and 35 controls (Apgar score greater than or equal to 7 at 1 min) matched for weight and gestation were followed up prospectively for neurodevelopmental outcome. ...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:To study the transcutaneous absorption of traditionally massaged oil in newborns and to specifically compare the effects of (i) essential fatty acid (EFA) rich - safflower oil and (ii) saturated fat rich coconut oil, on fatty acid profiles of massaged babies. DESIGN:A short term randomised controlled study. ...
journal_title:Indian pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To identify the factors influencing brain injury in infants with congenital heart disease (CHD) after cardiac surgery. METHODS:This retrospective study investigated 103 infants with CHD undergoing cardiac surgery between January 2013 and February 2016. Pre- and postoperative amplitude-integrated electroencep...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2020-02-15 00:00:00
abstract::Serial ultrasound scans were done in 300 fetuses between 16 to 24 weeks of gestation to establish the normogram of fetal kidney circumference (FKC) and fetal abdominal circumference (FAC) ratio (FKC/FAC). Of 300 fetuses, 150 fetuses were in the high risk group for fetal malformation and 150 patients were in the contro...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Improved survival seen in Acute Lymphoblastic Leukemia (ALL) cases has led to increased reports of second malignant neoplasms. CASE CHARACTERISTICS:A 12-year-old female treated for ALL using UK ALL XI protocol nine years back presented with progressively increasing pre-auricular swelling. OBSERVATION:Inves...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-015-0757-0
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To study the clinical and biochemical spectrum of Gaucher disease. DESIGN:Assay of beta glucosidase enzyme in leucocytes in patients with splenomegaly, and in chorionic villi for prenatal diagnosis. SETTING:Hospital-based. SUBJECTS:Of 13 cases of Gaucher disease, aged 1-6 years, 9 were identified at Delhi ...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::A 3 year old child was brought with fever, left parotid swelling and altered sensorium. Cultures from blood, pus and throat swab grew Burkholderia pseudomallei. A diagnosis of septicemic melioidosis with encephalopathy was made. She recovered following treatment with parenteral ceftazidime for 14 days, and 6 months of...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-010-0106-2
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To evaluate endothelial function and arterial mechanics in apparently healthy overweight adolescents. DESIGN:Analytical observational study. SETTING:Tertiary hospital. METHODS:40 asymptomatic, normotensive and non-smoking adolescents (11 to 18 years old) were evaluated. Of these 20 were overweight or obese...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of canakinumab on growth parameters of patients with autoinflammatory diseases. METHODS:This retrospective study included Colchicine resistant familial Mediterranean fever (FMF), Mevalonate kinase deficiency (MKD), Tumor necrosis factor receptor-associated periodic fever syndrome (TRAP...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2020-07-15 00:00:00