VOLUME REPLACEMENT IN INFANTS WITH DENGUE HEMORRHAGIC FEVER/DENGUE SHOCK SYNDROME

• Published in: The American journal of tropical medicine and hygiene Vol. 74; no. 4; pp. 684 - 691
• Main Authors: HUNG, NGUYEN THANH, LAN, NGUYEN TRONG, LEI, HUAN-YAO, LIN, YEE-SHIN, LIEN, LE BICH, HUANG, KAO-JEAN, LIN, CHIOU-FENG, HA, DO QUANG, HUONG, VU THI QUE, MY, LAM THI, YEH, TRAI-MING, HUANG, JYH-HSIUNG, LIU, CHING-CHUAN, HALSTEAD, SCOTT B
• Format: Journal Article
• Language: English
• Published: Lawrence, KS ASTMH 01.04.2006; Allen Press
• Subjects: Arboviroses; Biological and medical sciences; Blood Transfusion; Dengue fevers; Dextrans - administration & dosage; Female; Human viral diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Infusions, Intravenous; Male; Medical sciences; Outcome Assessment (Health Care); Plasma Substitutes - administration & dosage; Prospective Studies; Severe Dengue - pathology; Severe Dengue - therapy; Severity of Illness Index; Tropical viral diseases; Vietnam; Viral diseases; Asia; Vietnam; Human; Shock; Hemorrhagic fever; Dengue hemorrhagic fever; Dengue; Infant; Infection; Volume replacement; Treatment; Perfusion; Viral disease; Arbovirus disease; Tropical medicine
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.2006.74.684

Volume replacement was studied prospectively in 208 infants with dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). The mean volume of intravenous fluid used was 110.4 mL/kg administered over a mean period of 25.8 hours. The mean volumes of intravenous fluid replacement in infants with DSS was significantly higher than in those with non-shock DHF (129.8 mL/kg versus 102.1 mL/kg; P = 0.001). Patients with DSS had significantly higher proportional requirements for dextran and blood transfusions than non-shock infants. Recurrent shock, prolonged shock, and acute respiratory failure were recorded in 8, 6, and 13 patients, respectively. Four patients with DSS died of severe complications. Intravenous fluid replacement with special care to avoid fluid overload requires careful attention to established indications for use of colloidal solutions and blood transfusions. To improve case fatality rates, special efforts need to be directed to infants with DHF/DSS accompanied by severe complications.