KẾT QUẢ ĐIỀU TRỊ VÀ CÁC YẾU TỐ LIÊN QUAN ĐẾN THẤT BẠI KHI CHUYỂN TỪ DUNG DỊCH CAO PHÂN TỬ SANG ĐIỆN GIẢI Ở TRẺ EM SỐC SỐT XUẤT HUYẾT DENGUE TẠI BỆNH VIỆN SẢN NHI SÓC TRĂNG

Abstract

Background: Switching from colloid to crystalloid solutions is a pivotal decision in pediatric Dengue shock syndrome (DSS) management, yet predictors of failure are unclear. Objectives: To evaluate treatment outcomes and investigate factors related to failure when switching from CPT to crystalloid. Methods: A prospective study on 76 children with DSS at Soc Trang Obstetrics and Pediatrics Hospital from May 2024 – to July 2025. Transition failure was defined as hemodynamic instability or a ≥10% hematocrit increase within 2 hours of switching from colloid to crystalloid solutions cessation. Multiple logistic regression was used. Results: Survival rate was 100%; respiratory failure occurred in 74.3%. The transition failure rate was 36.8%. Four independent predictors for failure of switching from colloid to crystalloid solutions were identified: lactate ≥2 mmol/L at transition (OR=43.8), albumin <25 g/L at transition (OR=32.4), a ≥1.5-fold creatinine increase at transition (OR=13.1), and hematocrit ≥45% at shock onset (OR=5.8). The model showed good predictive value (AUC=0.877). Conclusion: Despite high survival, transition failure remains a challenge. Assessing the four factors (lactate, albumin, creatinine, Hct) is crucial for safely de-escalating fluid therapy.