ĐIỀU TRỊ SỐC SỐT XUẤT HUYẾT DENGUE KÉO DÀI, BIẾN CHỨNG NẶNG TẠI KHOA CẤP CỨU HỒI SỨC BỆNH VIỆN NHI ĐỒNG THÀNH PHỐ

Abstract

Background: To describe therapeutic interventions for children with prolonged Dengue shock syndrome (DDS) admitted at PICU, City children’s hospital  from January 2025 till August 2025.

Design: Prospective case series study

Results: 114 prolonged DDS children consisted of DSS (78,1%), severe DSS (21.9%), clinical findings included shock 100%, acute respiratory distress syndrome (ARDS) 22.8%, hepatic failure 28.1%, gastrointestinal bleeding 60.5%, multiple organ dysfunction syndrome 21.1%. Treatment encompassed average total amount of fluid of 192,4ml/kg in mean duration of 38.4 hours, where average one of colloid solution of 151.3 ml/kg, under monitor of central venous pressure (CVP) 69.3%, arterial blood pressure (IBP) 100%, respiratory support such as continuous positive airway pressure (CPAP) 100%, non-invasive ventilation 48.2%, mechanical ventilation 23.7%, abdominal paracentesis 26.3% with help of monitor of bladder pressure 71.9%; correction of coagulation disorder, GI bleeding such as  red cell package transfusion 73.7% with mean one of 14.5ml/kg, fresh frozen plasma (FFP) 57.9% with mean one of 18.3 ml/kg, cryoprecipitate 54.4% with mean one of 1.4 Unit/6kg, concentrated platelet 32.5% with mean one of 1.6 Unit/10kg; Average length of stay in PICU was 9.2 days, no death cases.

Conclusion: Modern medical instruments for respiratory, circulatory resuscitation should be equipped for province hospitals as well as high techniques such as mechanical ventilation, CRRT, monitor of IBP, bladder pressure should be handed over in order to save more children with severe DSS.