Review Jurnal- Athaya

7/23/2019 Review Jurnal- Athaya

http://slidepdf.com/reader/full/review-jurnal-athaya 1/5

REVIEW JURNAL

Background

Dengue shock syndrome (DSS) fluid resuscitation by following the World Health Organization

(WHO) guideline usually required large volumes of inger lactate (!) that might induce secondary

fluid overload" Our ob#ective was to com$are the effectiveness of the recommended volume of !

versus a smaller volume of a hy$ertonic sodium lactate solution (HS!) in children with DSS" %he

$rimary end $oint was to evaluate the effect of HS! on endothelial cell inflammation& assessed by

soluble vascular cell adhesion molecule' (s*+,') measurements" Secondarily& we considered the

effectiveness of HS! in restoring hemodynamic fluid balance& acid-base status& and sodium and

chloride balances& as well as in'hos$ital survival"

Methods

+ $ros$ective randomized single'blind clinical trial including ./ DSS children was conducted in the0ediatrics De$artment of Hasan Sadikin Hos$ital& 1andung& 2ndonesia" Only $ediatric $atients (3 to

4 years old) fulfilling the WHO criteria for DSS and new to resuscitation treatments were eligible"

0atients were resuscitated with either HS! (. ml5kg51W in . minutes followed by ml5kg51W5h

for 3 hours)& or ! (3/ ml5kg51W in . minutes followed by decreasing doses of /& 6& .& and 7

ml5kg 1W5h for 3 hours)"

Results

2n total& ./ $atients were randomized and included in outcome and adverse'event analysis8 49

$atients (:"3 ; /". years8 34"< ; "< kg8 mean ; S=,) com$leted the $rotocol and were fullyanalyzed (34 and 33 sub#ects in the HS! and ! grou$s& res$ectively)" 1aseline ($rebolus) data were

similar in both grou$s" Hemodynamic recovery& $lasma e>$ansion& clinical outcome& and survival

rate were not significantly different in the two grou$s& whereas fluid accumulation was one third

lower in the HS! than in the ! grou$" ,oreover& HS! was res$onsible for a $artial recovery from

endothelial dysfunction& as indicated by the significant decrease in s*+,'"

Conclusion

Similar hemodynamic shock recovery and $lasma e>$ansion were achieved in both grou$s des$ite

much lower fluid intake and fluid accumulation in the HS! grou$"

1



CRITICAL APPRIAL

" +$akah $ertanyaan $enelitian fokus dan #elas?

@a& $enelitian dilakukan untuk membandingkan keefektifan ringer laktat (!) dengan

hypertonic sodium lactate (HS!) $ada $asien dengan dengue shock syndrome (DSS)

3" Desain Studi?

0enelitian dilakukan dengan cara randomized single blind clinical trial

7" +$akah sub#ek $enelitian di$ilih secara te$at?

@a& kriteria inklusi yaitu $enelitian dilakukan $ada ./ anak (berusia 3 sam$ai 4

tahun) yang memenuhi kriteria DSS sesuai WHO dan $asien baru yang akan

menda$atkan tera$i cairan" Ariteria eksklusi yaitu 0asien dengan infeksi bakteri atau

virus lain& $enyakit gin#al berat& diare kronik& $enyakit hati& malnutrisi berat& diabetes

mellitus dan kelainan hematologi"

0enelitian dilakukan ke$ada $asien dari de$artemen anak umah Sakit Hasan Sadikin

1andung 2ndonesia $ada bulan ,ay 3//: hingga +$ril 3//<

2



4" +$akah semua hasil telah diukur secara akurat untuk meminimalisasi bias?

@a& sesuai dengan baseline quantitative dalam tabel

." +$akah data analisis sudah cuku$ te$at?

3



0erbandingan antara dua kelom$ok secara qualitative menggunakan fisher e>act test"

Sedangkan untuk keefektifan HS! untuk menurangi inflamasi sel endothelial dengan

menggunakan s+*,'"

9" +$akah hasil utama $enelitian?

%idak ditemukan $erbedaan yang signifikan dalam dari $emberian HS! mau$un !

$ada $asien dengan DSS" %eta$i $ada $asien dengan $emberian HS!& $eningkatan

tekanan darah lebih tinggi& akumulasi cairan untuk menghindari kelebihan cairan

lebih rendah dan da$at mengurangi kebocoran $lasma yang ter#adi dengan cara

mem$erbaiki fungsi dari sel endothelial dari$ada $emberian !

4



6" +$akah ada $ernyataan yang #elas mengenai hasil $enemuan?

ya& keterangan di cantumkan dalam diskusi

:" Da$atkah hasil $enelitian ini dia$likasikan $ada $o$ulasi lokal?

@a $enelitian ini dilakukan di bandung& 2ndonesia yang dimana 2ndonesia meru$akn

negera yang endemic demam berdarah"

5

Documents

Review Jurnal- Athaya