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Table 1 Response to fluid resuscitation in the two series to specifically examine the issue in adults with severe falciparum malaria

From: The fluid management of adults with severe malaria

 

VHS a [18]

PRISM b [25]

 

Baseline

Post-resuscitation c

Change

Baseline

Post-resuscitation c

Change

Plasma bicarbonate, mmol/L

13.9

12.8

-0.1

16.9

12.1

-1.9

(10.5 to 17)

(11.2 to 17.3)

(-1 to 1)

(13.8 to 17.8)

(13.7 to 15.4)

(-3.7 to -0.6)

Plasma lactate, mmol/L

6.3

6.3

-0.1

3.2

1.7

-1

(2.7 to 9)

(2.7 to 9)

(-0.6 to 0.4)

(1.9 to 5.4)

(1.4 to 3.1)

(-1.8 to 0.3)

pHd

7.36

7.35

-0.01

7.34

7.31

-0.05

(7.29 to 7.41)

(7.29 to 7.39)

(-0.01 to 0.01)

(7.32 to 7.37)

(7.24 to 7.34)

(-0.1 to 0.1)

Base deficit, mEq/L

11

13

0.6

9

13

3

(7 to 13)

(6 to 14)

(0.3 to 1.8)

(8 to 12)

(10 to 14)

(0 to 5)

Strong ion gap, mEq/Le

-

-

-

11.2

12.4

1.2

   

(7.2 to 15.2)

(9.4 to 15.2)

(-2.1 to 3.6)

CVP, cm H2O

2

5

3

5

10

6

(0 to 4)

(3 to 6)

(0 to 6)

(-2 to 8)

(7 to 14)

(1 to 10)

PAOP, mm Hgf

6

11

5

-

-

-

(4 to 7)

(8 to 12)

(2 to 8)

   

Heart rate, beats per minute

115

111

-6

101

99

0

(100 to 130)

(94 to 119)

(-11 to 0)

(93 to 112)

(90 to 110)

(-11 to 9)

Glasgow Coma Scale scoreg

8

-

-

12

14

0

(6 to 13)

  

(8 to 15)

(8 to 15)

(0 to 2)

MAP, mm Hg

79

79

1

88

94

7

(71 to 85)

(74 to 89)

(-2 to 7)

(79 to 98)

(82 to 108)

(-2 to 17)

Cardiac index, L/min per m2

4.06

5

0.63

3.08

3.64

0.49

(3.23 to 4.82)

(3.8 to 5.49)

(0.15 to 1.06)

(2.84 to 3.28)

(3.38 to 4.13)

(0.18 to 1.13)

DO2I, mL/min per m2

454

470

18

421

403

15

(341 to 557)

(371 to 578)

(-21 to 87)

(348 to 482)

(331 to 532)

(-90 to 86)

SVRI, dynes-sec/cm5 per m2

1,430

1,174

-139

2,155

1,926

-203

(1,193 to 2,039)

(945 to 1,874)

(-434 to -25)

(1,779 to 2,532)

(1,552 to 2,320)

(-751 to 170)

Hemoglobin, g/dL

8.8

7.4

-0.7

10.4

9.1

-1.6

7.2 to 10.8

(6.1 to 9.7)

(-1.6 to -0.1)

(8.5 to 12.6)

(7.1 to 10.5)

(-2.5 to -0.2)

SaO2/FiO2 ratio

436

484

0

455

443

-9

(374 to 575)

(360 to 552)

(-25 to 25)

(306 to 467)

(271 to 462)

(-23 to 2)

GEDVI, mL/m2e

-

-

-

472

585

91

(429 to 571)

(539 to 638)

(10 to 126)

EVLW, mL/kge

-

-

-

8

10

1

(6 to 9)

(8 to 11)

(1 to 3)

PVPIe

-

-

-

2.29

2.25

0.05

(1.82 to 2.45)

(1.97 to 2.6)

(-0.16 to 0.32)

Plasma creatinine, μmol/Lg

339

-

-

158

132

-26

(220 to 572)

  

(106 to 255)

(88 to 211)

(-62 to 18)

  1. Values are presented as the median (interquartile range). aMedian (range) of 3,230 mL (1,035 to 7,000) over the initial 6 hours and 5,450 mL (1,985 to 13,720) over the first 24 hours. bMedian (range) fluid bolus of 918 mL (350 to 2,000) was delivered over a median (range) of 75 minutes (30 to 225). cPost-initial resuscitation in the Vietnamese Hemodynamic Study (VHS), post-6 hours of fluid resuscitation in PiCCO-guided Resuscitation in Severe Malaria (PRISM) except plasma creatinine which was assessed after 24 hours. dpH: arterial in VHS, central venous in PRISM. eNot measured in VHS. fNot measured in PRISM. gAs fluid load occurred over a median of only 75 minutes in VHS, Glasgow Coma Scale score and plasma creatinine were not repeated immediately post-resuscitation. CVP, central venous pressure; DO2I, oxygen delivery; EVLW, extravascular lung water; GEDVI, global end-diastolic volume index; MAP, mean arterial pressure; PAOP, pulmonary artery occlusion pressure; PVPI, pulmonary vascular permeability index; SaO2/FiO2, oxygen saturation (percentage)/fraction of inspired oxygen; SVRI, systemic vascular resistance index.
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