RESUMO
Electronic database Medline, Embase, Cochrane Library and Lilacs were used to retrieve the clinical trials that will evaluate the various therapeutical options available for management of hemorrhagic dengue. Eight clinical studies were included. Supportive care and symptomatic treatment through hydration and aggressive fluid management, if hypotension develops in the course of disease, are the most important aids to improve survival. Treatment with corticosteroids such as methylprednisolone, hydrocortisone, carbazochorome sodium sulfonate (AC-17) and recombinant activated factor VII did not reduce mortality in children with hemorrhagic dengue. At present, no vaccine or effective antiviral treatment is available for the prevention or treatment of hemorrhagic dengue.
Assuntos
Gerenciamento Clínico , Dengue Grave/terapia , Corticosteroides/uso terapêutico , Adrenocromo/análogos & derivados , Adrenocromo/uso terapêutico , Antipiréticos/uso terapêutico , Criança , Ensaios Clínicos como Assunto/estatística & dados numéricos , Coloides/uso terapêutico , Colômbia , Terapia Combinada , Soluções Cristaloides , Método Duplo-Cego , Quimioterapia Combinada , Fator VIIa/uso terapêutico , Hidratação , Hemorragia/tratamento farmacológico , Hemorragia/etiologia , Hemostáticos/uso terapêutico , Humanos , Soluções Isotônicas/uso terapêutico , Oxigenoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Proteínas Recombinantes/uso terapêutico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Dengue Grave/complicações , Dengue Grave/tratamento farmacológico , Choque/etiologia , Choque/terapiaRESUMO
OBJECTIVE: We studied the ability of carbazochrome sodium sulfonate (AC-17) to prevent capillary permeability in dengue hemorrhagic fever/dengue shock syndrome. METHOD: A randomized, placebo-controlled trial in 95 children stratified by age and sex was conducted in two hospitals during 1992. AC-17 (n = 45 cases) or B vitamins as placebo (n = 50) were given as a bolus infusion and then as a continuous drip for 24 hours; a total of 300 mg of AC-17 was administered on the first 2 days and 150 mg on the third day. RESULTS: The two groups were comparable in age, sex, duration of illness, and clinical manifestations. No significant difference in shock or pleural effusion was noted between the two groups. Shock developed in 8.9% (4/45) of patients in the AC-17 group and 6% (3/50) in the placebo group (p = 0.44). Pleural effusion was found at 0, 24, 48, and 72 hours after admission in 4.4%, 20%, 31.1%, and 20% in the AC-17 group and 2%, 14%, 28%, and 14% in the placebo group, respectively. CONCLUSION: Administration of AC-17 does not prevent plasma leakage or shock in dengue hemorrhagic fever/dengue shock syndrome.