Evidence map›Paper›PMID 26581060›Full record

Trial reportPloS one2015

The Safety of a Conservative Fluid Replacement Strategy in Adults Hospitalised with Malaria.

Ne Myo Aung, Myat Kaung, Tint Tint Kyi, Myat Phone Kyaw, Myo Min, Zaw Win Htet, Nicholas M Anstey, Mar Mar Kyi, Josh Hanson

Open access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 22 citations in OpenAlex.

  1. Review
  2. Review
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
  8. Severe malaria: what's new on the pathogenesis front?International journal for parasitology · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Ne Myo AungInsein General Hospital, Yangon, Myanmar.
Myat KaungHpa-an Hospital, Hpa-an, Kayin State, Myanmar.
Tint Tint KyiInsein General Hospital, Yangon, Myanmar.
Myat Phone KyawDepartment of Medical Research (Lower Myanmar), Yangon, Myanmar.
Myo MinMyanmar Medical Association, Yangon, Myanmar.
Zaw Win HtetInsein General Hospital, Yangon, Myanmar.
Nicholas M AnsteyMenzies School of Health Research, Charles Darwin University, Darwin, Australia.
Mar Mar KyiInsein General Hospital, Yangon, Myanmar.
Josh HansonMenzies School of Health Research, Charles Darwin University, Darwin, Australia.
East Yangon General Hospital · MMCharles Darwin University · AUMenzies School of Health Research · AUMyanmar Oxford Clinical Research Unit · MMTechnological University Hpa-An · MM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA conservative approach to fluid resuscitation improves survival in children with severe malaria; however, this strategy has not been formally evaluated in adults with the disease.

methodsAdults hospitalised with malaria at two tertiary referral hospitals in Myanmar received intravenous fluid replacement with isotonic saline, administered at a maintenance rate using a simple weight-based algorithm. Clinical and biochemical indices were followed sequentially.

resultsOf 61 adults enrolled, 34 (56%) had Plasmodium falciparum mono-infection, 17 (28%) Plasmodium vivax mono-infection and 10 (16%) mixed infection; 27 (44%) patients were at high risk of death (P. falciparum infection and RCAM score ≥ 2). In the first six hours of hospitalisation patients received a mean 1.7 ml/kg/hour (range: 1.3-2.2) of intravenous fluid and were able to drink a mean of 0.8 ml/kg/hour (range: 0-3). Intravenous fluid administration and oral intake were similar for the remainder of the first 48 hours of hospitalisation. All 61 patients survived to discharge. No patient developed Adult Respiratory Distress Syndrome, a requirement for renal replacement therapy or hypotension (mean arterial pressure < 60 mmHg). Plasma lactate was elevated (> 2 mmol/L) on enrolment in 26 (43%) patients but had declined by 6 hours in 25 (96%) and was declining at 24 hours in the other patient. Plasma creatinine was elevated (> 120 μmol/L) on enrolment in 17 (28%) patients, but was normal or falling in 16 (94%) at 48 hours and declining in the other patient by 72 hours. There was no clinically meaningful increase in plasma lactate or creatinine in any patient with a normal value on enrolment. Patients receiving fluid replacement with the conservative fluid replacement algorithm were more likely to survive than historical controls in the same hospitals who had received fluid replacement guided by clinical judgement in the year prior to the study (p = 0.03), despite having more severe disease (p < 0.001).

conclusionsA conservative fluid resuscitation strategy appears safe in adults hospitalised with malaria.

Indexed as

HospitalizationAcidosis, LacticAdministration, OralAdultCase-Control StudiesCreatinineElectrolytesFluid TherapyHumansInjections, IntravenousKidneyKidney Function TestsLactatesMalariaMyanmarSurvival RateCreatinineElectrolytesLactates

Identifiers

PMID26581060
PMCPMC4651424
OpenAlexW2175122437

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.