The relationship between pleural effusion index and mortality in children with dengue shock syndrome

  • Novianti Hawarini Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital. Semarang
  • Muhammad Sholeh Kosim Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital. Semarang
  • Mohammad Supriatna Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital. Semarang
  • Yusrina Istanti Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital. Semarang
  • Eddy Sudjanto Department of Radiology, Diponegoro University Medical School/Dr. Kariadi Hospital. Semarang
Keywords: pleural effusion index, mortality, dengue shock syndrome

Abstract

Background Dengue shock syndrome (DSS) mortality rate is still
high. The extent of plasma effusion in dengue shock syndrome
can be identified in the right lateral decubitus position on chest
xô€ƒray, and quantified by the pleural effusion index (PEl). It is
thought that PEl value can be used to predict DSS mortality in
children. Pleural effusion in DSS patients can cause respiratory
failure and death.
Objective To determine the relationship bet ween PEl and
mortality in children \\lith DSS.
Methods This crossô€ƒsectional, retrospective study was held in the
Dr. Kariadi Hospital, Semarang, Indonesia. Data was taken from
medical records of pediatric intensive care unit (PICU) patients
with DSS from January 2009 to January 2011. DSS diagnosis
was confirmed by clinical and radiological manifestations. PEl
diagnosis was established by the presence of fluid in the pleural
cavity on pulmonary radiological examinations. Xô€ƒrays were
interpreted by the radiologist on duty at the time. Chi square and
logistic regression tests were used to analyze the data.
Results There were 48 subjects with DSS, consisting of 18 males
(37.5 %), and 30 females (62.5%). Twentyô€ƒnine subjects (60.4%)
survived and 19 (39.6%) died. One patient (2.1 %) had PEl <6%,
4 (8.3%) had PEl 6-15%, 17 (35.4%) had PEl 15-30%, and
26 (54.2%) had PEl> 30% on their xô€ƒrays. The mortality rate
of DSS with PEl 15-30% was 11.8% (95% CI 0.021 to 0.564;
P<0.005) and PEl >30% was 65.4 % (95% CI 3,581 to 99,642;
P <0.005).
Cone-lution PEl> 15% was a risk factor for mortality in children
with DSS. [Paediatr lndanes. 2012;52:239-42].

References

1. N go NT, Cao XT, Kneen R, Wills B, Nguyen VM, Nguyen
TQ, et al. Acute management of dengue shock syndrome: a randomized double-blind comparison of 4 intravenous fluid
regimens in the first hour. Clin Infect Dis. 2001;32:204-13.
2. Soegijanto S, Budiyanto, Kartika, Taufik, Amor. Update
management of dengue complication in pediatric. Indonesian
J Trop Infect Dis. 2011;2,1-11.
3. Catharina S, Tatty E. S, Eric CM, Robert J D, et al. Risk
factors for mortality in dengue shock syndrome (DSS). Media
Medika Indonesiana. 2009;43:213-9.
4. Agaral R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur A,
et al. A clinical study of the patients Mth dengue hemorrhagic
fever during the epidemic of 1996 at Lucknow, India.
Southeast Asian J Trop Med Public Health. 1999;30m5-40.
5. World Health Organization (WHO) Regional Office for
South-East Asia. Guidelines for treatment of dengue fever!
dengue hemorrhagic fever in small hospitals. New Delhi:
WHO Regional Officer for South East Asia; 1999.
6. Alkrinawi S, Chernick V. Pleural fluid in hospitalized
pediatric patients. Clin Pediatr. 1996;35:5-9.
7. Syahrial R, Sukonco K, Iwan E. Radiologi diagnostik. Jakarta:
Gaya Baru; 1998. p. 115-8.
8. Sathupan P, KhongphattanayothinA, SrisaiJ, Srikaew K. The
role of vascular endothelial growth factor leading to vascular
leakage in children with dengue virus infection. Ann Trop
Paediatr. 2007;n 179-84.
9. Vaughn DW, Green S, Kalayanarooj S, Innis BL, Nimmannitya
S, Suntayakom S, et al. Dengue in the early febrile phase:
viremia and antibody responses. J Infect Dis. 1997; 176:322-
30.
10. Committee of Epidemic Diseases. Surveillance for dengue
fever/dengue hemorrhagic fever in Singapore. Epidemiological
News Bulletin (Singapore). 2002;28,25-30.
11. World Health Organization (WHO). Guidelines for case
reporting and management. Dengue fever and fengue
hemorrhagic fever. New Delhi: WHO Regional Office for
South-East Asia; 1999.
12. Supriatna MS. Perbedaan gangguan fungsi hati pada demam
berdarah dengue [master's thesis]. [Semarang]: Diponegoro
University; 2004.
13. Setiati T E. Pengelolaan syok pada demam berdarah dengue
anak. In: Sutaryo,Hagung P, Mulatsih S, editors. Tatalaksana syok dan perdarahan pada demam berdarah dengue.
Yogyakarta, Medika FK UGM; 2004. p. 75-86.
14. Rigau􀁀Perez JG, Clark GG, Gubler DJ, Reiter P, Sanders
EJ, Vorndam A V. Dengue and dengue haemorrhagic fever.
Lancet. 1998;352,911-7.
15. Setiati TE. Faktor hemostasis dan faktor kebocoran vaskular
sebagai faktor diskriminan untuk memprediksi syok pada DBD [dissertation]. [Semarang] :Diponegoro University;
2004.
16. Pramuljo HS. Peran pencitraan pada demam berdarah
dengue. In: Harun SR, Satari HI, editors. Naskah len gkap
pelatihan bagi pelatih dokter spesialis anak dan dokter
spesialis penyakit dalam. Jakarta: BP FKUI; 2000. p. 63􀁀
72.
Published
2012-08-31
How to Cite
1.
Hawarini N, Kosim M, Supriatna M, Istanti Y, Sudjanto E. The relationship between pleural effusion index and mortality in children with dengue shock syndrome. PI [Internet]. 31Aug.2012 [cited 13Nov.2024];52(4):239-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/404
Section
Articles
Received 2016-08-31
Accepted 2016-08-31
Published 2012-08-31