Methods

1. RESPONSE TO SUCCINYLATED GELATIN 4% IN THE MANAGEMENT OF DENGUE SHOCK SYNDROME AT CIPTO MANGUNKUSUMO HOSPITAL IN 2006-2007 Matahari Harumdini, Mulya Rahma Karyanti Department of Child Health, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital Jakarta Background Dengue shock syndrome (DSS) is a major cause of morbidity and mortality in Indonesia It is characterized by a massive increase of systemic capillary permeability leading to hypovolemic shock Fluid resuscitation is crucial to overcome plasma leakage by giving crystalloid initially, continued with colloid Objective To evaluate the clinical and laboratory response of succinylated gelatin 4%, a modified fluid gelatin (MFG), in the management of DSS. Methods Retrospective study includes DSS patients received MFG for resuscitation after receiving crystalloid at CM Hospital in 2006-2007 DSS was confirmed by serologic examination Outcome measures were clinical and laboratory responses. Results Of 95 DSS patients, 38 patients received MFG and had complete medical record data for the study Median age was 5-years old (0.42-16.5) Median day of fever at shock was 5th day (3-7) Spontaneous bleeding was found in 27 (71.1%) Pleural effusion was found in all patients who underwent thorax x-ray Median hematocrit was 43%vol (32.1-53.4) Median thrombocyte was 54000/l (11000-152000) Most patients (63.1%) recover from shock in <30 minutes Characteristics of subjects Table 3. Duration of infusion and hospitalization Side effects Of 11 patients who had no bleeding at first presentation, 4 patients had new bleeding (3 hematemesis and 1 melena) 9/15 patients had prolonged PT/PTT 6/14 patients had metabolic acidosis Side effects were probably not caused by colloid given, otherwise by DSS itself No allergic reaction was found Figure 1. Clinical response Mortality Three (7.9%) patientsdied : • 1/3 patients due to respiratory failure • 2/3 patients due to massive bleeding Conclusions Table 2. Etiology of recurrent shock MFG is effective for managing DSS and no important adverse effects were found. Further study with larger sample is necessary to compare MFG with other colloids. KONIKA, Surabaya 5-9July 2008