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City Children’s Hospital saved the lives of many children with severe dengue shock, complications of respiratory failure and multi-organ damage.

In the past two weeks, City Children’s Hospital has saved many lives of children with severe dengue shock and respiratory failure complications. coagulopathy, gastrointestinal bleeding, liver damage, multi-organ failure. Case 1, child Tr. M. Kh. 14 years old, male, weight 72 kg, overweight (at this age, weight is about 45-50kg), living in Tam Binh, Vinh Long History: 4 days, N1-N3: fever 39 degrees Celsius, headache, muscle pain. N4 children with no fever, abdominal pain, vomiting, lethargy, cold hands and feet, were admitted to a local hospital with a difficult pulse, difficult to measure blood pressure, Hct 57%, platelets 1100/microL, received anti-shock fluids according to the protocol. , then transferred to City Children’s Hospital. Here, the child also showed cardiogenic shock 130 l/min, blood pressure 100/80 mmHg, Hct 50%, dyspnea, traction breathing 42 l/min. Diagnosis of severe Dengue hemorrhagic fever N4 re-shock, prolonged shock, liver damage, respiratory failure, overweight/obesity, continued anti-shock fluid therapy under the guidance of CVP, invasive arterial blood pressure invasive procedures, oxygen support, CPAP then intubation to help breathing, measure bladder pressure, blood transfusion, fresh frozen plasma, cryoprecipitate, platelet concentrate, support liver therapy. The state of respiratory failure due to peritoneal effusion, large pleural effusion, bladder pressure increased to 47cm H2O was punctured to drain the peritoneal fluid to decompress. Results after nearly 1 week of treatment, the child’s condition improved gradually, the child was weaned from the ventilator, breathing air, and was awake.

Case 2, child with septicemia, 5 years old, male, weighing 20 kg, living in Duc Hoa, Long An, history of fever for 4 days, day 5 of shock, was admitted to a local hospital in a state of deep shock, receiving intravenous fluids. anti-shock according to the protocol, then transferred to City Children’s Hospital, in a state of prolonged shock, respiratory failure, coagulopathy, liver damage, received anti-shock fluid, respiratory support, mechanical ventilation, puncture peritoneal drainage, decompression, blood transfusion and blood products, supportive treatment of the liver, correction of blood acidosis. Results after more than 1 week of treatment, the child’s condition gradually improved, weaned from the ventilator, and were awake.

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Cases 3 and 4 include 2 boys, both 11 years old and overweight, weighing 55 kg TXQ B, Ph. HS 53 kg (normally about 40-45 kg at this age), lives in Long An, Ben Tre. Both children entered shock on day 5 of the disease and progressed to prolonged shock and complications of respiratory failure, coagulopathy, gastrointestinal bleeding, liver damage, and were actively treated with HES 130 macromolecule infusion. 6% combined with 10% albumin, non-invasive mechanical ventilation support, the condition improved gradually after 4-5 days of treatment. These are the cases where the application of macromolecule and albumin infusion helps to improve shock and respiratory failure in children with septic shock.

In the fifth case, child Ph. N. Th. K. 4 years old, female, weight 22kg, overweight (normally around 16-18kg in this age group), lives in Hoc Mon, Ho Chi Minh City. History recorded for 5 days, N1-4 had a high fever continuously, N5 children had no fever, vomited with brown fever, fever, cold feet, so they were admitted to the local hospital in a state of mild pulse, difficult to detect blood pressure, difficult to measure, Hct 49%, platelets 13000/microL initial shock infusion, then transferred to City Children’s Hospital. Here, the children also showed deep shock, respiratory failure, gastrointestinal bleeding, black stools, anti-shock fluids, CPAP respiratory support, non-invasive, invasive mechanical ventilation, peritoneal drainage. decompression, blood transfusion, blood products, liver support therapy, severe progression, prolonged shock, liver damage, severe kidney disease, multi-organ failure, continuous dialysis 3 cycles. Results after more than 2 weeks of treatment, the child’s condition gradually improved, kidney function returned to normal, the child was weaned from the ventilator, and was awake.

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It is also worth mentioning that parents actively kill mosquitoes, swarms, sleep under mosquito nets and need to monitor and detect early signs to take their children to medical facilities in time. That is, if you see a child with a high fever for more than 2 days, showing one of the following signs, you need to take the child to the hospital immediately.

  • Irritability, irritability, irritability or lethargy
  • Stomachache
  • Nosebleeds, bloody teeth or vomiting blood, black stools
  • Cold hands and feet, lying in one place not playing, giving up sucking, eating and drinking
Young Tr.  M. Kh.  14 years old, male, weight 72 kg, overweight, severe dengue shock, anti-shock, invasive mechanical ventilation, peritoneal drainage.
Young Tr. M. Kh. 14 years old, male, weight 72 kg, overweight, severe dengue shock, anti-shock, invasive mechanical ventilation, peritoneal drainage.
Children with NKBM, 5 years old, male, weighing 20 kg, severe dengue shock, receiving anti-shock, invasive mechanical ventilation, peritoneal drainage.
Children with NKBM, 5 years old, male, weighing 20 kg, severe dengue shock, receiving anti-shock, invasive mechanical ventilation, peritoneal drainage.
In the case of 2 boys, both 11 years old and overweight, the child's weight Ph.  HS 53 kg, living in Ben Tre TXQ B 55 kg living in Long An, severe dengue shock, shock with HES 130 6% and 10% albumin, non-invasive mechanical ventilation,
In the case of 2 boys, both 11 years old and overweight, the child’s weight Ph. HS 53 kg, living in Ben Tre TXQ B 55 kg living in Long An, severe dengue shock, shock with HES 130 6% and 10% albumin, non-invasive mechanical ventilation,
Young Ph.  N. Th.  K. 4 years old, female, weight 22kg, overweight, severe dengue shock, multi-organ failure received continuous dialysis, helping to restore organ damage.
Young Ph. N. Th. K. 4 years old, female, weight 22kg, overweight, severe dengue shock, multi-organ failure received continuous dialysis, helping to restore organ damage.

Doctor 2 Nguyen Minh Tien
City Children’s Hospital

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