• Luan Thanh Vo, Dat Tat Nguyen, Thinh Ngoc Tran, Hang Hoang-Thanh Tran, Trang Thi-Hoai Đoan, Tram Ngoc Pham, Thanh Thi-Hoai Mai, Quynh Xuan-Thuy Nguyen, Thuan Khac Nguyen, Thuong Thi-Kim Nguyen, Sakib Burza, and Thanh Tat Nguyen.
• Department of Infectious Diseases, Children Hospital No. 2, Ho Chi Minh City, Vietnam.
• Pediatr Crit Care Me. 2024 Apr 1; 25 (4): e177e185e177-e185.

ObjectivesProfound dengue shock syndrome (DSS) complicated by severe respiratory failure necessitating mechanical ventilation (MV) accounts for high case fatality rates among PICU-admitted patients. A major challenge to management is the assessment of intravascular volume, which can be hampered by severe plasma leakage and the use of MV.DesignRetrospective cohort, from 2013 to 2021.PatientsSixty-seven children with profound DSS supported by MV, some of whom underwent bedside point-of-care ultrasound (POCUS) for assessment and monitoring of hemodynamics and fluid administration.SettingPICU of the tertiary Children's Hospital No. 2 in Vietnam.InterventionsNone.Measurements And Main ResultsWe analyzed data clinical and laboratory data during PICU stay. In particular, during use of MV (i.e., at times 0-, 6-, and 24-hr after commencement) and fluid resuscitation. The primary study outcome was 28-day in-hospital mortality, and the secondary outcomes were associations with changes in hemodynamics, blood lactate, and vasoactive-inotrope score (VIS). Patients had a median age of 7 years (interquartile range, 4-9). Use of POCUS during fluid management (39/67), as opposed to not using (28/67), was associated with lower mortality (6/39 [15%] vs. 18/28 [64%]; difference 49 % [95% CI, 28-70%], p < 0.001). Use of POCUS was associated with lower odds of death (adjusted odds ratio 0.17 [95% CI, 0.04-0.76], p = 0.02). The utilization of POCUS, versus not, was associated with greater use of resuscitation fluid, and reductions in VIS and pediatric logistic organ dysfunction (PELOD-2) score at 24 hours after MV and PICU discharge.ConclusionsIn our experience of pediatric patients with profound DSS and undergoing MV (2013-2021), POCUS use was associated with lower odds of death, a higher volume of resuscitation fluid, and improvements in the blood lactate levels, VIS, and PELOD-2 score.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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