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Presented by :
Christina Quinones Marquez MD
Mary Mediatrixs Medical Center
Article
Profound DSS
Either a) requirement for two or more colloid
boluses ( either for crystalloid resuscitation for
compensated shock at presentation plus two or
more episodes of recurrent shock or colloid
resuscitation for decompensateds shock plus one
or more episodes of recurrent shock
B) requirement of inotropes in addition to colloid
therapy to maintain cardiovascular stability
Hemodynamic Status
(1) when PP greater than or equal 10
mmHg and SBP is maintained above the lower
limit of normal age
(2) when PP less than or equal 10
mmHg and SBP is below the lower limit of
normal age
(3) if blood pressure is unmeasurable
Research methodology
Lam PK, Hoai Tam DT, Dung NM, Hanh Tien NT, Thanh Kieu NT, et al. (2015) A Prognostic Model for Development of Profound
Shock among Children Presenting with Dengue Shock Syndrome. PLOS ONE 10(5): e0126134.
https://doi.org/10.1371/journal.pone.0126134
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0126134
Table 1. Baseline characteristics and outcomes of study participants (N = 1207) continuation.
Lam PK, Hoai Tam DT, Dung NM, Hanh Tien NT, Thanh Kieu NT, et al. (2015) A Prognostic Model for Development of Profound
Shock among Children Presenting with Dengue Shock Syndrome. PLOS ONE 10(5): e0126134.
https://doi.org/10.1371/journal.pone.0126134
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0126134
Results
Independent Risk Factors identified
ASSOCIATED for both the development of
Profound Dengue Shock and Recurrent
Shock are the following
A) Younger Age
B) Earlier Day of Presentation
C) Higher Pulse Rate
D) Higher temperature
E) For Females, worse hemodynamic status
at presentation
Results
Lam PK, Hoai Tam DT, Dung NM, Hanh Tien NT, Thanh Kieu NT, et al. (2015) A Prognostic Model for Development of Profound
Shock among Children Presenting with Dengue Shock Syndrome. PLOS ONE 10(5): e0126134.
https://doi.org/10.1371/journal.pone.0126134
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0126134
Example
Single institution
Definition of clinical outcomes
Could vary from one institution, and country
Critical appraisal
Objectives
To identify risk factors for the development of
profound and recurrent shock among children
with dengue shock syndrome
Develop a prediction model for the development
of profound and recurrent shock amongst children
with dengue shock syndrome
Critical appraisal
Objectives
To identify risk factors for the development of
profound and recurrent shock among children
with dengue shock syndrome
Develop a prediction model for the development
of profound and recurrent shock amongst children
with dengue shock syndrome
Critical appraisal
YES
Critical appraisal
YES
Conclusion