Paediatric dengue shock syndrome and acute respiratory failure: a single-centre retrospective study

Area of Science:

• Pediatrics
• Infectious Diseases
• Critical Care Medicine

Background:

• Dengue Shock Syndrome (DSS) is a severe dengue complication causing significant mortality in tropical regions.
• Acute Respiratory Failure (ARF) is a critical complication of DSS and a primary driver of dengue-related deaths.
• Identifying risk factors for ARF in pediatric DSS patients is vital for improving outcomes.

Purpose of the Study:

• To determine the risk factors associated with the development of Acute Respiratory Failure (ARF) in children diagnosed with Dengue Shock Syndrome (DSS).

Main Methods:

• A retrospective review of pediatric patients with DSS admitted to a Paediatric Intensive Care Unit (PICU) between 2010 and 2020.
• Data collected included patient demographics, clinical parameters, and laboratory results.
• Multivariable logistic regression analysis was employed to identify independent risk factors for ARF.

Main Results:

• Of 60 children with DSS, 26 (43.3%) developed ARF; 6 patients did not survive to day 28.
• Greater fluid accumulation within the first 72 hours of PICU admission was observed in the ARF group (12.2%) compared to the non-ARF group (8.3%).
• Over 15% fluid accumulation at 72 hours post-PICU admission was independently associated with ARF (adjusted OR 5.67, p=0.025).

Conclusions:

• Acute Respiratory Failure (ARF) represents a significant complication in pediatric patients with Dengue Shock Syndrome (DSS).
• Close monitoring of fluid status is essential for early identification of patients at high risk for ARF.
• Judicious fluid management, particularly after hemodynamic stabilization and reduced fluid leakage, is critical to prevent ARF in DSS patients.