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dc.contributor.author Yeo, TW
dc.contributor.author Lampah, DA
dc.contributor.author Gitawati, R
dc.contributor.author Tjitra, E
dc.contributor.author Kenangalem, E
dc.contributor.author Granger, DL
dc.contributor.author Weinberg, JB
dc.contributor.author Lopansri, BK
dc.contributor.author Price, RN
dc.contributor.author Celermajer, DS
dc.contributor.author Duffull, SB
dc.contributor.author Anstey, NM
dc.coverage.spatial United States
dc.date.accessioned 2011-06-21T17:31:24Z
dc.date.issued 2008-06-11
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/18545693
dc.identifier.citation PLoS One, 2008, 3 (6), pp. e2347 - ?
dc.identifier.uri http://hdl.handle.net/10161/4494
dc.description.abstract BACKGROUND: L-arginine infusion improves endothelial function in malaria but its safety profile has not been described in detail. We assessed clinical symptoms, hemodynamic status and biochemical parameters before and after a single L-arginine infusion in adults with moderately severe malaria. METHODOLOGY AND FINDINGS: In an ascending dose study, adjunctive intravenous L-arginine hydrochloride was infused over 30 minutes in doses of 3 g, 6 g and 12 g to three separate groups of 10 adults hospitalized with moderately severe Plasmodium falciparum malaria in addition to standard quinine therapy. Symptoms, vital signs and selected biochemical measurements were assessed before, during, and for 24 hours after infusion. No new or worsening symptoms developed apart from mild discomfort at the intravenous cannula site in two patients. There was a dose-response relationship between increasing mg/kg dose and the maximum decrease in systolic (rho = 0.463; Spearman's, p = 0.02) and diastolic blood pressure (r = 0.42; Pearson's, p = 0.02), and with the maximum increment in blood potassium (r = 0.70, p<0.001) and maximum decrement in bicarbonate concentrations (r = 0.53, p = 0.003) and pH (r = 0.48, p = 0.007). At the highest dose (12 g), changes in blood pressure and electrolytes were not clinically significant, with a mean maximum decrease in mean arterial blood pressure of 6 mmHg (range: 0-11; p<0.001), mean maximal increase in potassium of 0.5 mmol/L (range 0.2-0.7 mmol/L; p<0.001), and mean maximal decrease in bicarbonate of 3 mEq/L (range 1-7; p<0.01) without a significant change in pH. There was no significant dose-response relationship with blood phosphate, lactate, anion gap and glucose concentrations. All patients had an uncomplicated clinical recovery. CONCLUSIONS/SIGNIFICANCE: Infusion of up to 12 g of intravenous L-arginine hydrochloride over 30 minutes is well tolerated in adults with moderately severe malaria, with no clinically important changes in hemodynamic or biochemical status. Trials of adjunctive L-arginine can be extended to phase 2 studies in severe malaria. TRIAL REGISTRATION: ClinicalTrials.gov NCT00147368.
dc.format.extent e2347 - ?
dc.language eng
dc.language.iso en_US en_US
dc.relation.ispartof PLoS One
dc.relation.isversionof 10.1371/journal.pone.0002347
dc.subject Adult
dc.subject Arginine
dc.subject Blood Glucose
dc.subject Blood Pressure
dc.subject Dose-Response Relationship, Drug
dc.subject Electrolytes
dc.subject Humans
dc.subject Hydrogen-Ion Concentration
dc.subject Infusions, Intravenous
dc.subject Malaria, Falciparum
dc.title Safety profile of L-arginine infusion in moderately severe falciparum malaria.
dc.title.alternative en_US
dc.type Journal Article
dc.description.version Version of Record en_US
duke.date.pubdate 2008-6-11 en_US
duke.description.endpage e2347 en_US
duke.description.issue 6 en_US
duke.description.startpage e2347 en_US
duke.description.volume 3 en_US
dc.relation.journal Plos One en_US
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/18545693
pubs.issue 6
pubs.organisational-group /Duke
pubs.organisational-group /Duke/Institutes and Provost's Academic Units
pubs.organisational-group /Duke/Institutes and Provost's Academic Units/University Institutes and Centers
pubs.organisational-group /Duke/Institutes and Provost's Academic Units/University Institutes and Centers/Global Health Institute
pubs.organisational-group /Duke/School of Medicine
pubs.organisational-group /Duke/School of Medicine/Basic Science Departments
pubs.organisational-group /Duke/School of Medicine/Basic Science Departments/Immunology
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine/Medicine, Hematology
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Obstetrics and Gynecology
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers/Duke Cancer Institute
pubs.publication-status Published online
pubs.volume 3
dc.identifier.eissn 1932-6203

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