Faculty Opinions recommendation of Fluid resuscitation of adults with severe falciparum malaria: effects on Acid-base status, renal function, and extravascular lung water.

Abstract Introduction: It is unclear whether residual renal function (RRF) in dialysis patients can attenuate the metabolic impact of the long 68-hour interdialytic interval, in which water, acid, and electrolyte accumulation occurs. Objective: to evaluate serum electrolyte levels, water balance, and acid-base status in dialytic patients with and without RRF over the long interdialytic interval (LII). Methodology: this was a single-center, cross-sectional, and analytical study that compared patients with and without RRF, defined by diuresis above 200 mL in 24 hours. Patients were weighed and serum samples were collected for biochemical and gasometric analysis at the beginning and at the end of the LII. Results: 27 and 24 patients with and without RRF were evaluated, respectively. Patients without RRF had a higher increase in serum potassium during the LII (2.67 x 1.14 mEq/L, p < 0.001), reaching higher values at the end of the study (6.8 x 5.72 mEq/L, p < 0.001) and lower pH value at the beginning of the interval (7.40 x 7.43, p = 0.018). More patients with serum bicarbonate < 18 mEq/L (50 x 14.8%, p = 0.007) and mixed acid-base disorder (57.7 x 29.2%, p = 0.042), as well as greater interdialytic weight gain (14.67 x 8.87 mL/kg/h, p < 0.001) and lower natremia (137 x 139 mEq/L, p = 0.02) at the end of the interval. Calcemia and phosphatemia were not different between the groups. Conclusion: Patients with RRF had better control of serum potassium, sodium, acid-base status, and volemia throughout the LII.

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Influence of Renal Function and Diet on Acid-Base Status in Chronic Kidney Disease Patients

Journal of Renal Nutrition ◽

10.1053/j.jrn.2008.08.010 ◽

2009 ◽

Vol 19 (2) ◽

pp. 178-182 ◽

Cited By ~ 10

Author(s):

Viviane O. Leal ◽

Alvimar G. Delgado ◽

Maurilo Leite ◽

William E. Mitch ◽

Denise Mafra

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Acid Base ◽

Acid Base Status

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Dietary Cation-Anion Difference, Acid-Base Status, Mineral Metabolism, Renal Function, and Milk Production of Lactating Cows

Journal of Dairy Science ◽

10.3168/jds.s0022-0302(95)76853-9 ◽

1995 ◽

Vol 78 (10) ◽

pp. 2259-2284 ◽

Cited By ~ 27

Author(s):

Annick M. Delaquis ◽

Elliot Block

Keyword(s):

Renal Function ◽

Milk Production ◽

Mineral Metabolism ◽

Acid Base ◽

Lactating Cows ◽

Acid Base Status

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A Retrospective Analysis of the Haemodynamic and Metabolic Effects of Fluid Resuscitation in Vietnamese Adults with Severe Falciparum Malaria

PLoS ONE ◽

10.1371/journal.pone.0025523 ◽

2011 ◽

Vol 6 (10) ◽

pp. e25523 ◽

Cited By ~ 16

Author(s):

Nguyen Hoan Phu ◽

Josh Hanson ◽

Delia Bethell ◽

Nguyen Thi Hoang Mai ◽

Tran Thi Hong Chau ◽

...

Keyword(s):

Retrospective Analysis ◽

Falciparum Malaria ◽

Fluid Resuscitation ◽

Metabolic Effects ◽

Severe Falciparum Malaria

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The Effect in the Acid-Base Status, Electrolyte Levels and Anion-Gap Following Fluid Resuscitation with Normal Saline, Lactated Ringers and Isotonic Electrolyte Solution Fluids Among Pediatric Patients

10.26226/morressier.5fa2cf404d4e91fe5c54b83c ◽

2020 ◽

Author(s):

Mary Joy Torres

Keyword(s):

Electrolyte Solution ◽

Fluid Resuscitation ◽

Normal Saline ◽

Pediatric Patients ◽

Anion Gap ◽

Acid Base ◽

Acid Base Status

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Associations Between Restrictive Fluid Management and Renal Function and Tissue Perfusion in Adults With Severe Falciparum Malaria: A Prospective Observational Study

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz449 ◽

2019 ◽

Vol 221 (2) ◽

pp. 285-292

Author(s):

Haruhiko Ishioka ◽

Katherine Plewes ◽

Rajyabardhan Pattnaik ◽

Hugh W F Kingston ◽

Stije J Leopold ◽

...

Keyword(s):

Renal Function ◽

Observational Study ◽

Falciparum Malaria ◽

Prospective Observational Study ◽

Fluid Intake ◽

Fluid Management ◽

Tissue Perfusion ◽

Total Fluid Intake ◽

Severe Falciparum Malaria ◽

Total Fluid

Abstract Background Liberal fluid resuscitation has proved harmful in adults with severe malaria, but the level of restriction has not been defined. Methods In a prospective observational study in adults with severe falciparum malaria, restrictive fluid management was provided at the discretion of the treating physician. The relationships between the volume of fluid and changes in renal function or tissue perfusion were evaluated. Results A total of 154 patients were studied, 41 (26.6%) of whom died. Median total fluid intake during the first 6 and 24 hours from enrollment was 3.3 (interquartile range [IQR], 1.8–5.1) mL/kg per hour and 2.2 (IQR, 1.6–3.2) mL/kg per hour, respectively. Total fluid intake at 6 hours was not correlated with changes in plasma creatinine at 24 hours (n = 116; rs = 0.16; P = .089) or lactate at 6 hours (n = 94; rs = −0.05; P = .660). Development of hypotensive shock or pulmonary edema within 24 hours after enrollment were not related to the volume of fluid administration. Conclusions Restrictive fluid management did not worsen kidney function and tissue perfusion in adult patients with severe falciparum malaria. We suggest crystalloid administration of 2–3 mL/kg per hour during the first 24 hours without bolus therapy, unless the patient is hypotensive.

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