title: Comparison of the effects of oral hydration and intravenous fluid replacement in adult patients with non-shock dengue hemorrhagic fever in Taiwan.
abstract: The level of plasma leakage is mild to moderate in patients with non-shock dengue hemorrhagic fever (DHF grade I and grade II), and the necessity of intravenous fluid replacement for these patients remains controversial. We conducted an observational study in adult patients (>18 years) with non-shock DHF admitted to a medical centre in southern Taiwan comparing the effects of oral hydration [group 1 (n=19); age (mean+/-SD) 54.6+/-15.5 years] and intravenous fluid replacement, with a volume of >40ml/kg/day in the first 72h of hospitalization [group 2 (n=30); age 55.9+/-11.6 years]. No significant difference was found in demographics, clinical manifestations, and mean peak level of hematocrit between the two groups. Patients in group 2 had a significantly longer hospital stay compared to those in group 1 (P=0.007), and there was a trend suggesting patients in group 2 were prone to develop pleural effusion and/or pulmonary edema. No difference was found in daily mean pulse pressure, mean hematocrit level, and mean platelet count between the groups for the duration of the 7 days in hospital. All 49 patients survived. Our data suggest that oral hydration may be as effective as intravenous fluid replacement for adults with non-shock DHF and this warrants investigation in a larger series of patients.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien 833, Taiwan.
authors.forename: Ing-Kit
authors.initials: IK
authors.lastname: Lee
authors.forename: Wen-Huei
authors.initials: WH
authors.lastname: Lee
authors.forename: Kuender D
authors.initials: KD
authors.lastname: Yang
authors.forename: Jien-Wei
authors.initials: JW
authors.lastname: Liu
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D003716:Dengue Virus / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006400:Hematocrit; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012307:Risk Factors; D019595:Severe Dengue / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral