Organ Dysfunction in Severe Dengue among Children in a Vietnamese Hospital

Abstract

Nguyen The Nguyen Phung, Qui Nguyen Dinh, Tung Huu Trinh, Diep Tuan Tran.

Background: Dengue fever (DF) is an infectious disease with a high incidence in most developing countries, and organ dysfunction is a serious complication of the disease that can lead to death in children. The aims of study to identify the clinical and subclinical characteristics of organ dysfunction in severe dengue fever at Children Hospital N2, Ho Chi Minh City.
Methods: A retrospective descriptive study of 403 cases of severe DF in children admitted to the Department of Infectious Disease at Children Hospital N2 from January 2013 to December 2015.
Results: Characteristics of organ dysfunction: Circulatory: 87.3% had shock, comprising 22.7% severe shock, 9.7% prolonged shock, 11.9% re-shocked, and 3.4% re-shocked multiple times. Respiratory: 26.3% respiratory failure, comprising 17.9% ARDS with 89% at medium-severe levels. 23.8% severe liver injury. 4% acute kidney injury. 18.9% had upper gastrointestinal bleeding with 8.6% severe level. 73.2% coagulopathy and 17.1% met the disseminated intravascular coagulation (DIC) standards. Neurological: 6.2% had cognitive disorders, and 5.2% had convulsions during treatment. Metabolism: 9.2% severe metabolic acidosis; 5.5% hypoglycaemia, 74.6% hyponatremia; 10.1% hypocalcaemia. The death rate in the study was 4.2%.
Conclusions: Organ dysfunction mainly comprised circulatory failure, respiratory failure, coagulopathy, severe liver injury, and gastrointestinal bleeding. Patients with acute kidney injury, DIC, elevated liver enzymes (>1,000 UI/L), and cognitive disorders are high risk factors for death.