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2019, Number 2

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Rev Cubana Pediatr 2019; 91 (2)

Usefulness of warning signs´ identification in children and adolescents with dengue

Izquierdo EA, Martínez TE

Language: Spanish
References: 27
Page: 1-13
PDF size: 243.22 Kb.


ABSTRACT

Introduction: Dengue is a disease that is capable of producing an important plasma extravasation with hypovolaemia and shock, which are frequent signs of seriousness and causes of death.
Objective: To value the usefulness of warning signs identification in children and adolescents with dengue.
Methods: A prospective study was carried out to 110 children (0-18 years old, both sexes) at “Dr. Angel A. Aballi” University Pediatric Hospital who had confirmed dengue´s warning signs and were admitted to the Intensive Care Unit and treated with crystalloids solutions by intravenous route. An equivalent number of confirmed dengue patients who did not have warning signs nor received that treatment were the control group. Clinical data and the results of laboratory tests were recorded since patients were admitted in the Intensive Care (ICU) and after 6 hours of treatment. The 2009 World Health Organization (WHO) Dengue Classification was used to classify patients retrospectively and a comparison was made with the WHO 1977 Dengue Classification.
Results: Clinical warning signs that were more frequently identified were: intensive and continuous abdominal pain (50 %) and frequent vomiting (3 or more in 4 hours) (34.3 %) that appeared during defervescence (46 % of patients), and half of them presented ascites. After 6 hours of treatment with the crystalloids solutions, the number of patients with abdominal pain decreased to 30% and those with low cardiac output (hypotension) from 35 % to 10 %. No fatalities occurred.
Conclusions: Warning signs of severe dengue, which identification has been recommended by WHO and PAHO and also in the Cuban Guidelines, has special importance in the care of hospitalized children and adolescents; and it was demonstrated its usefulness in the prevention of severity as in the improvement of the signs of severity when those were treated in the onset period.


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