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Original Article
- Infection
- Excessive fluid resuscitation is associated with intensive care unit mortality in Pakistani patients with dengue shock syndrome
- Moiz Salahuddin, Rameesha Khalid, Sadaf Hanif, Filza Naeem, Rameen Aijaz, Akbar Shoukat Ali
- Acute Crit Care. 2025;40(2):235-243. Published online May 22, 2025
- DOI: https://doi.org/10.4266/acc.004008
- 5,982 View
- 113 Download
- 3 Web of Science
- 4 Crossref
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Abstract
PDF - Background
The mortality of severe dengue infections is approximately 23%. In the management of dengue shock syndrome (DSS), aggressive fluid resuscitation is recommended. The primary objective of our study was to assess the factors associated with 30-day mortality in DSS patients.
Methods
Adult patients >18 years old, who were admitted with DSS were included. DSS was diagnosed in patients who required vasopressors or had lactic acidosis >4 mmol/L. Patients were divided into three different groups based on cumulative fluid balance at death or extubation: group I (<3.5 L), group II (3.5–8.0 L), and group III (>8.0 L).
Results
A total of 135 patients with DSS was included, with an overall 30-day mortality of 74.8%. The average Sequential Organ Failure Assessment (SOFA) score on intensive care unit admission was 12.2. Mechanical ventilation was required in 112 patients (83.0%), with 61 patients (45.2%) being intubated without a noninvasive ventilation trial. Respiratory failure was the most common reason for requiring intubation (65 patients, 48.2%). In survivors, the median cumulative fluid balance was 1,493 ml (interquartile range [IQR], 0–4,501 ml), whereas that in the mortality group was 7,797 ml (IQR, 3,700–13,600 ml). On multivariate analysis, SOFA score (odds ratio [OR], 1.220; 95% CI, 1.011–1.472; P=0.038) and having received >8.0 L cumulative fluid balance (OR, 6.682; 95% CI, 1.808–24.689; P=0.004) were associated with increased risk of mortality.
Conclusions
DSS patients have high mortality rates. High SOFA scores and >8.0 L cumulative fluid balance may indicate worse outcomes. -
Citations
Citations to this article as recorded by
- An optimal risk score for early plasma leakage prediction in adult dengue patients: A multicenter study
Thang Van Dao, Binh Nhu Do, Minh Duc Pham, Tung Huu Ha, Hoang Cong Nguyen, Vinh Hai Vu, Hoa Thi Le, Phuoc Ba Nguyen, Thu Thi Hoang, Duc Minh Cap, Kien Trung Nguyen, Tuyen Van Duong
Acta Tropica.2026; 278: 108110. CrossRef - Integrating structured point-of-care ultrasound into dengue fever management: A mini review and comprehensive clinical guide
Zhi-Yuan Lee, Wei-Ven Chin
World Journal of Critical Care Medicine.2026;[Epub] CrossRef - Unveiling the molecular mechanism of Qingwen Baidu decoction against dengue fever: an integrated study of bioinformatic analysis, machine learning and network pharmacology
Yan Xiao, Zhanchen Liu, Shengjie Hu, Peng Yao, Yajun Liu, Maosheng Cheng
Functional & Integrative Genomics.2026;[Epub] CrossRef - Comment on “Excessive fluid resuscitation is associated with intensive care unit mortality in Pakistani patients with dengue shock syndrome”
Hinpetch Daungsupawong, Viroj Wiwanitkit
Acute and Critical Care.2025; 40(4): 630. CrossRef
- An optimal risk score for early plasma leakage prediction in adult dengue patients: A multicenter study
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