A novel intervention altering disease course in children with dengue: an observational study


  • Ramakrishna Myathari Department of Pediatrics, Sarvodaya Hospital, Sector 19, Faridabad, Haryana, India
  • Anand Gupta Department of Pediatrics, Sarvodaya Hospital, Sector 19, Faridabad, Haryana, India




Dengue fever, Albumin transfusion, Dengue shock syndrome


Background: Dengue fever has emerged as a global public health problem in recent decade, clinical spectrum of disease ranges from mild fever to life threatening dengue shock syndrome. The disease is characterized by thrombocytopenia, hypoalbuminemia and increased capillary permeability leading to third space fluid loss viz ascites, pleural effusion pericardial effusion. This study aims to show that therapeutic intervention (viz albumin transfusion under supervised diuretic cover) during onset of critical phase significantly reduces progression of disease, morbidity and mortality.

Methods: In this observational study enrolled confirmed dengue cases, requiring hospitalization. Basic lab parameters viz complete blood count, liver functions, renal functions, C-reactive proteins, chest X-ray were obtained. Pre requisites prior to albumin infusion were; urine output >0.8 ml/kg/hour, normal renal functions and no shock/hypotension.

Results: We found improved outcomes using this intervention in dengue patients early identification of onset of critical phase and intervening during that phase significantly reduced the morbidity/mortality. Out of remaining 78 cases, 24 children developed critical phase, they were managed and transfused albumin infusion under diuretic cover. None of children who received albumin transfusion had mortality.

Conclusions: Early identification of onset of critical phase and intervening during that phase significantly reduced the morbidity/mortality as well duration of ICU/hospital stay. We believe albumin transfusion under supervised diuretic cover, also preventing development of major life-threatening complications viz dengue shock syndrome.


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