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Nguyen HB, Loomba M, Yang JJ, Jacobsen G, Shah K, Otero RM, dkk. Early lactate clearance is associated with biomarkers of inflammation, oagulatio, apoptosis, organ dysfunction, and mortality in severe sepsis and septic shock. JIR. 2010;7(6):1-11.

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Article

Impact of Hyperosmolar Sodium-Lactate Resuscitation on Lactate Clearance in Pediatric Severe Sepsis

1Department of Child Health, Hasan Sadikin General Hospital-Universitas Padjadjaran, Bandung, Indonesia


American Journal of Epidemiology and Infectious Disease. 2015, Vol. 3 No. 4, 76-79
DOI: 10.12691/ajeid-3-4-1
Copyright © 2015 Science and Education Publishing

Cite this paper:
Nevin Chandra Junarsa, Dadang Hudaya Somasetia, Dedi Rachmadi Sambas. Impact of Hyperosmolar Sodium-Lactate Resuscitation on Lactate Clearance in Pediatric Severe Sepsis. American Journal of Epidemiology and Infectious Disease. 2015; 3(4):76-79. doi: 10.12691/ajeid-3-4-1.

Correspondence to: Nevin  Chandra Junarsa, Department of Child Health, Hasan Sadikin General Hospital-Universitas Padjadjaran, Bandung, Indonesia. Email: nevinchandra@yahoo.com

Abstract

Background: Fluid resuscitation with normal saline (NS) could aggravate lactate production. Our objective was to compare the impact the of small volume resuscitation using hyperosmolar sodium-lactate (HSL) versus NS in pediatric severe sepsis. The primary endpoint was the increased of lactate clearance after 1 and 6 hours of fluid resuscitation. The secondary endpoint was the incidence of fluid overload and serum sodium level. Methodology and principal findings: A clinical trial study on 34 severe sepsis children was conducted in Hasan Sadikin Hospital Bandung, Indonesia. Eligible subjects were newly diagnosed severe sepsis children (1−14 years old). Patients were resuscitated with either HSL (bolus of 5 mL/kgBW, repeated if no response and followed by 1 mL/kgBW/hour for 12 hours), or NS (bolus of 20 mL/kgBW, repeated if no response and followed by maintenance fluid requirement). If shock persisted, inotropes and/or catecholamine were commenced. HSL group had significant higher 1 hour and 6 hours lactate clearance compared to NS group (p<0.05 and <0.01 respectively). HSL group had significant lower incidence of fluid overload compared to NS group (p<0.001). HSL and NS group had no significant difference serum sodium level after fluid resuscitation (p=0.601). Conclusions: There was an impact of HSL on lactate clearance after 1 and 6 hours fluid resuscitation. As lower fluid overload incidence was observed in HSL group, HSL solution might likely to be a promising fluid for small volume resuscitation in severe sepsis children.

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