K R Bharath Kumar Reddy1, G V Basavaraja. 1. Department of Pediatric Intensive Care, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India. Correspondence to: Dr KR Bharath Kumar Reddy, Indira Gandhi Institute of Child Health, South Health Complex, Dharmaram Post, Bangalore 560 029, Karnataka, India. bharathreddykr@yahoo.co.in.
Abstract
OBJECTIVES: To study the role of furosemide infusion in the management of Acute respiratory distress syndrome (ARDS) associated with dengue fever. METHODS: Children between the ages of 1 month to 18 years, who fulfilled the WHO clinical criteria for dengue infection and American European Consensus Criteria criteria for ARDS with Dengue IgM positivity, were evaluated. Patients were studied as group D (receiving diuretic therapy alone) and group B (both ventilation and diuretics), and compared to a historical control group V (ventilation alone). Furosemide infusion was administered at 0.05-0.1 mg/kg/hour for 48 hours, maintaining a urine output of 2-4 mL/kg/hour. RESULTS: There was a significant difference in survival in the three groups. Significant difference was noted between pre- and post-intervention arterial blood gases with respect to PCO2 (P=0.02), pO2 (P=0.003), PaO2/FaO2 ratio (P<0.001) and alveolar-arteriolar oxygen gradient (P=0.002). CONCLUSION: Diuretic infusion improves outcome in dengue with ARDS.
OBJECTIVES: To study the role of furosemide infusion in the management of Acute respiratory distress syndrome (ARDS) associated with dengue fever. METHODS:Children between the ages of 1 month to 18 years, who fulfilled the WHO clinical criteria for dengue infection and American European Consensus Criteria criteria for ARDS with Dengue IgM positivity, were evaluated. Patients were studied as group D (receiving diuretic therapy alone) and group B (both ventilation and diuretics), and compared to a historical control group V (ventilation alone). Furosemide infusion was administered at 0.05-0.1 mg/kg/hour for 48 hours, maintaining a urine output of 2-4 mL/kg/hour. RESULTS: There was a significant difference in survival in the three groups. Significant difference was noted between pre- and post-intervention arterial blood gases with respect to PCO2 (P=0.02), pO2 (P=0.003), PaO2/FaO2 ratio (P<0.001) and alveolar-arteriolar oxygen gradient (P=0.002). CONCLUSION: Diuretic infusion improves outcome in dengue with ARDS.
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