Background: Fluid therapy for dengue shock syndrome (DSS) requires a dynamic approach that involves monitoring of the pathophysiological processes as well as the preload, contractility, and afterload assessment during the course dengue infection. Hemodynamically unstable DSS patients received in referral setting often complicated by fluid overload and secondary infection. Objective: This study aims to provide hemodynamic profiles and fluid responsiveness of pediatric patients admitted to the PICU with DSS. Methods: Hemodynamic profiles, laboratories, and demographic data were collected from patients aged 1 month to 18 years old with DSS who were admitted to the Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January to December 2016. Hemodynamic profiles were assessed in clinically shock and not clinically shock group at PICU admission using the non-invasive Ultrasonic Cardiac Output Monitor (USCOM). Fluid responsiveness in clinically shock group was evaluated after fluid challenge with 10 ml/kgBW crystalloid or colloid. Results: Eighty six subjects were included in this study. Sixty six subjects were admitted to PICU with clinically shock condition. This group received less intravenous fluid than hemodynamically stable group (6.9 vs 7.52 ml/kgBW/hour respectively), had higher mean hematocrit level (42.09% vs 40.32% respectively), had higher hematocrit level during PICU stay (43.37% vs 42.06% respectively), significantly higher percentage to receive inotropes agent (62,1% vs 5%, p 0,000) and longer duration of inotropes usage (23,5 vs 0 hours, p 0.72). From the clinically shock patients admitted to PICU, only 19,69% were fluid responsive. Other subjects in this group with fluid non responsive state, 90,38% had low inotropic index and high systemic vascular resistance index. Among 8 patients in clinically shock group who died during PICU stay, 6 of them had low cardiac Index, fluid non responsive condition, low inotropic index and high systemic vascular resistance index. Conclusion: Only a small percentage of DSS patients with clinically shock admitted to the PICU were fluid responsive. Majority of DSS cases in children had low inotropy index and high systemic vascular resistance index.
| Published in | American Journal of Pediatrics (Volume 5, Issue 4) |
| DOI | 10.11648/j.ajp.20190504.26 |
| Page(s) | 260-266 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Dengue Shock Syndrome, Initial Hemodynamic Profiles
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APA Style
Desy Rusmawatiningtyas, Putu Aditya Wiguna, Intan Fatah Kumara, Nurnaningsih, Saptadi Yuliarto, et al. (2019). Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings. American Journal of Pediatrics, 5(4), 260-266. https://doi.org/10.11648/j.ajp.20190504.26
ACS Style
Desy Rusmawatiningtyas; Putu Aditya Wiguna; Intan Fatah Kumara; Nurnaningsih; Saptadi Yuliarto, et al. Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings. Am. J. Pediatr. 2019, 5(4), 260-266. doi: 10.11648/j.ajp.20190504.26
AMA Style
Desy Rusmawatiningtyas, Putu Aditya Wiguna, Intan Fatah Kumara, Nurnaningsih, Saptadi Yuliarto, et al. Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings. Am J Pediatr. 2019;5(4):260-266. doi: 10.11648/j.ajp.20190504.26
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Download@article{10.11648/j.ajp.20190504.26,
author = {Desy Rusmawatiningtyas and Putu Aditya Wiguna and Intan Fatah Kumara and Nurnaningsih and Saptadi Yuliarto and Eggi Arguni and Antonius Pudjiadi and Sutaryo},
title = {Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings},
journal = {American Journal of Pediatrics},
volume = {5},
number = {4},
pages = {260-266},
doi = {10.11648/j.ajp.20190504.26},
url = {https://doi.org/10.11648/j.ajp.20190504.26},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.26},
abstract = {Background: Fluid therapy for dengue shock syndrome (DSS) requires a dynamic approach that involves monitoring of the pathophysiological processes as well as the preload, contractility, and afterload assessment during the course dengue infection. Hemodynamically unstable DSS patients received in referral setting often complicated by fluid overload and secondary infection. Objective: This study aims to provide hemodynamic profiles and fluid responsiveness of pediatric patients admitted to the PICU with DSS. Methods: Hemodynamic profiles, laboratories, and demographic data were collected from patients aged 1 month to 18 years old with DSS who were admitted to the Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January to December 2016. Hemodynamic profiles were assessed in clinically shock and not clinically shock group at PICU admission using the non-invasive Ultrasonic Cardiac Output Monitor (USCOM). Fluid responsiveness in clinically shock group was evaluated after fluid challenge with 10 ml/kgBW crystalloid or colloid. Results: Eighty six subjects were included in this study. Sixty six subjects were admitted to PICU with clinically shock condition. This group received less intravenous fluid than hemodynamically stable group (6.9 vs 7.52 ml/kgBW/hour respectively), had higher mean hematocrit level (42.09% vs 40.32% respectively), had higher hematocrit level during PICU stay (43.37% vs 42.06% respectively), significantly higher percentage to receive inotropes agent (62,1% vs 5%, p 0,000) and longer duration of inotropes usage (23,5 vs 0 hours, p 0.72). From the clinically shock patients admitted to PICU, only 19,69% were fluid responsive. Other subjects in this group with fluid non responsive state, 90,38% had low inotropic index and high systemic vascular resistance index. Among 8 patients in clinically shock group who died during PICU stay, 6 of them had low cardiac Index, fluid non responsive condition, low inotropic index and high systemic vascular resistance index. Conclusion: Only a small percentage of DSS patients with clinically shock admitted to the PICU were fluid responsive. Majority of DSS cases in children had low inotropy index and high systemic vascular resistance index.},
year = {2019}
}
TY - JOUR T1 - Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings AU - Desy Rusmawatiningtyas AU - Putu Aditya Wiguna AU - Intan Fatah Kumara AU - Nurnaningsih AU - Saptadi Yuliarto AU - Eggi Arguni AU - Antonius Pudjiadi AU - Sutaryo Y1 - 2019/11/19 PY - 2019 N1 - https://doi.org/10.11648/j.ajp.20190504.26 DO - 10.11648/j.ajp.20190504.26 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 260 EP - 266 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20190504.26 AB - Background: Fluid therapy for dengue shock syndrome (DSS) requires a dynamic approach that involves monitoring of the pathophysiological processes as well as the preload, contractility, and afterload assessment during the course dengue infection. Hemodynamically unstable DSS patients received in referral setting often complicated by fluid overload and secondary infection. Objective: This study aims to provide hemodynamic profiles and fluid responsiveness of pediatric patients admitted to the PICU with DSS. Methods: Hemodynamic profiles, laboratories, and demographic data were collected from patients aged 1 month to 18 years old with DSS who were admitted to the Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January to December 2016. Hemodynamic profiles were assessed in clinically shock and not clinically shock group at PICU admission using the non-invasive Ultrasonic Cardiac Output Monitor (USCOM). Fluid responsiveness in clinically shock group was evaluated after fluid challenge with 10 ml/kgBW crystalloid or colloid. Results: Eighty six subjects were included in this study. Sixty six subjects were admitted to PICU with clinically shock condition. This group received less intravenous fluid than hemodynamically stable group (6.9 vs 7.52 ml/kgBW/hour respectively), had higher mean hematocrit level (42.09% vs 40.32% respectively), had higher hematocrit level during PICU stay (43.37% vs 42.06% respectively), significantly higher percentage to receive inotropes agent (62,1% vs 5%, p 0,000) and longer duration of inotropes usage (23,5 vs 0 hours, p 0.72). From the clinically shock patients admitted to PICU, only 19,69% were fluid responsive. Other subjects in this group with fluid non responsive state, 90,38% had low inotropic index and high systemic vascular resistance index. Among 8 patients in clinically shock group who died during PICU stay, 6 of them had low cardiac Index, fluid non responsive condition, low inotropic index and high systemic vascular resistance index. Conclusion: Only a small percentage of DSS patients with clinically shock admitted to the PICU were fluid responsive. Majority of DSS cases in children had low inotropy index and high systemic vascular resistance index. VL - 5 IS - 4 ER -
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