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Suryadi Nicolaas Napoleon Tatura
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Health Professions Medicine & Pharmacology

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Comparison of blood plasma and gelatin solution in resuscitation of children with dengue shock syndrome Suryadi Nicolaas Napoleon Tatura; Novie Homenta Rampengan; Jose Meky Mandei; Ari Lukas Runtunuwu; Max FJ Mantik; Tony Homenta Rampengan
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (146.109 KB) | DOI: 10.14238/pi49.6.2009.322-9

Abstract

Background Dengue shock syndrome (DSS) is characterized bysevere vascular leakage and hemostasis disorder. It is the cause of death in 1 to 5 percent of cases. WH 0 management guidelines for resuscitation remain empirical rather than evidence-based.Objective To find out the alternative fluids to replace plasmaleakage in DSS.Methods We performed a prospective study and randomizedcomparison of plasma and gelatin solution for resuscitation ofIndonesian children with DSS. We randomly assigned 25 subjectswith DSS to receive plasma and 25 children to receive gelatinfluid. Statistical analyse were performed using chi-square test,Fisher's exact test, t test, Mann-Whitney test.Results The increment of pulse pressure width and the decrement of hematocrit in subjects treated with gelatin were higher than that of plasma atfour-hour therapy (P=0.002 and P=0.017). Only one patient died caused by unusually manifestation of DSS. The increment of body temperature in subjects treated with plasma was higher than that of gelatin at four-hour therapy (P=O.Oll). The decrement of platelet count in subjects treated with gelatin were less than that of plasma (P=0.018). The increment of diuresis rate in subjects treated with gelatin was higher than that of plasma at twenty-hour therapy (P<O.OOOl). The decrement of respiratory rate in subjects treated with gelatin was higher than that of plasmaat twenty-eight hour therapy (P=0.018). There was no differencein studied variables : total volume rate, blood pressure, pulse rate, re-shock rate, clinical fluid overload, allergy reactions, bleeding manifestations, and length of stay (P>0.05).Conclusions Gelatin solution can be used as volume replacementin resuscitation of DSS if blood plasma is not available especiallyat four-hour therapy.
Neutrophil-lymphocyte ratio and D-dimer to predict outcomes of length of hospitalization and mortality of COVID-19 in children Suryadi Nicolaas Napoleon Tatura; Susan Nathalia Budihardjo; Johny Lambert Rompis; David Soelingan Waworuntu; Vivekenanda Pateda
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

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Abstract

Background Biomarkers such as the neutrophil-to-lymphocyte ratio (NLR) and D-dimer have proven predictive of mortality in adults with COVID-19, but their utility in pediatric patients remains underexplored. Objective To evaluate for associations between NLR and D-dimer with hospital length of hospitalization and mortality in children. Methods This retrospective cross-sectional study analyzed pediatric COVID-19 cases at Prof. Dr. R.D. Kandou Hospital, Manado (January 2021–September 2022). Children aged 1 month to 18 years with confirmed SARS-CoV-2 by RT-PCR were included. Children with incomplete data or immuno-compromised status were excluded. Data on demographics and laboratory parameters were analyzed using descriptive statistics, correlation, and linear regression Results This study included 65 pediatric COVID-19 patients, with a median age of 60 months and a balanced gender distribution. The median NLR was 1.3 (IQR 0.8–2.4), and the median D-dimer was 1.1 (IQR 0.4–11.0) mg/L. Three patients (5%) died, and the median length of hospitalization was 10 (IQR 7–16) days. No significant correlation was found between NLR and D-dimer (r=0.07; P=0.576). Similarly, NLR was not associated with length of hospital hospitalization (r=0.20; P=0.120) or with mortality (P=0.482). D-dimer levels, in contrast, demonstrated a strong positive association with length of hospitalization (r=0.59; P<0.001) but were not significantly correlated with mortality (P=0.316). Although not statistically significant, D-dimer levels tended to be higher in non-survivors compared to survivors. In regression analysis, higher D-dimer levels were independently associated with longer hospitalization duration (β=0.49; 95% CI 0.29 to 0.70; P<0.001) after adjusting for NLR, age, and platelet count. However, NLR showed no significant relationship with either hospitalization duration or mortality. Conclusion Pediatric COVID-19 patients showed normal NLR and elevated D-dimer levels. Elevated D-dimer is associated with prolonged hospitalization, but not with mortality.
Co-Authors Ari Lukas Runtunuwu David Soelingan Waworuntu Johny Lambert Rompis Jose Meky Mandei Max FJ Mantik Novie Homenta Rampengan Susan Nathalia Budihardjo Tony Homenta Rampengan Vivekenanda Pateda