Serial bedside echocardiography identifies children at risk of recurrent Dengue shock: a prospective cohort study.
| Title: | Serial bedside echocardiography identifies children at risk of recurrent Dengue shock: a prospective cohort study. |
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| Authors: | Chanh HQ; Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Cho Quan Ward, Ho Chi Minh City, Vietnam. chanhhq@oucru.org.; Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. chanhhq@oucru.org.; Trieu HT; Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Cho Quan Ward, Ho Chi Minh City, Vietnam.; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; Vuong NL; Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Cho Quan Ward, Ho Chi Minh City, Vietnam.; University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.; Tran KH; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; Huynh NTV; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; Phan TQ; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; Duyen HTL; Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Cho Quan Ward, Ho Chi Minh City, Vietnam.; Kieu NTT; Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Cho Quan Ward, Ho Chi Minh City, Vietnam.; Nguyen Minh N; Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Cho Quan Ward, Ho Chi Minh City, Vietnam.; Tam DTH; Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Cho Quan Ward, Ho Chi Minh City, Vietnam.; Lam PK; National University of Singapore, Singapore, Singapore.; Mcbride A; Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.; Wills B; Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.; Yacoub S; Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. |
| Source: | BMC emergency medicine [BMC Emerg Med] 2026 Mar 25; Vol. 26 (1). Date of Electronic Publication: 2026 Mar 25. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968543 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-227X (Electronic) Linking ISSN: 1471227X NLM ISO Abbreviation: BMC Emerg Med Subsets: MEDLINE; In Process |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| Competing Interests: | Declarations. Ethics approval and consent to participate: The investigators declared that this study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approvals for this study were obtained from the Oxford Tropical Research Ethics Committee (03–18) and the HTD Ethics Committee (CS/BND/18/27). For each participant, written informed consent was obtained from a parent/guardian, together with assent from children ≥ 12 years. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. |
| References: | Yacoub S, Wertheim H, Simmons CP, Screaton G, Wills B. Cardiovascular manifestations of the emerging dengue pandemic. Nat Rev Cardiol [Internet]. 2014;11(6):335–45. Available from: https://doi.org/10.1038/nrcardio.2014.40 .; Mansanguan C, Hanboonkunupakarn B, Muangnoicharoen S, Huntrup A, Poolcharoen A, Mansanguan S et al. Cardiac evaluation in adults with dengue virus infection by serial echocardiography. BMC Infect Dis [Internet]. 2021;21(1):940. Available from: https://doi.org/10.1186/s12879-021-06639-x .; Wali JP, Biswas A, Chandra S, Malhotra A, Aggarwal P, Handa R, et al. Cardiac involvement in dengue haemorrhagic fever. Int J Cardiol. 1998;64(1):31–6. (PMID: 10.1016/S0167-5273(98)00008-49579814); Khongphatthanayothin A, Suesaowalak M, Muangmingsook S, Bhattarakosol P, Pancharoen C. Hemodynamic profiles of patients with dengue hemorrhagic fever during toxic stage: an echocardiographic study. Intensive Care Med. 2003;29:570–4. (PMID: 10.1007/s00134-003-1671-912595978); Yacoub S, Griffiths A, Hong Chau TT, Simmons CP, Wills B, Hien TT et al. Cardiac function in Vietnamese patients with different dengue severity grades*. Crit Care Med [Internet]. 2012;40(2). Available from: https://journals.lww.com/ccmjournal/Fulltext/2012/02000/Cardiac_function_in_Vietnamese_patients_with.16.aspx .; Nhan NT, Phuong CXT, Kneen R, Wills B, Van My N, Phuong NTQ, 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(2):204–13. (PMID: 10.1086/318479); Lam PK, Hoai Tam DT, Dung NM, Hanh Tien NT, Thanh Kieu NT, Simmons C et al. A prognostic model for development of profound shock among children presenting with dengue shock syndrome. PLoS One [Internet]. 2015;10(5):e0126134-. Available from: https://doi.org/10.1371/journal.pone.0126134 .; Yacoub S, Trung TH, Lam PK, Thien VHN, Hai DHT, Phan TQ, et al. Cardio-haemodynamic assessment and venous lactate in severe dengue: relationship with recurrent shock and respiratory distress. PLoS Negl Trop Dis. 2017;11(7):e0005740. (PMID: 10.1371/journal.pntd.0005740286926755519203); Vincent JL, Joosten A, Saugel B. Hemodynamic monitoring and support. Crit Care Med [Internet]. 2021;49(10). Available from: https://journals.lww.com/ccmjournal/fulltext/2021/10000/hemodynamic_monitoring_and_support.4.aspx .; Chanh HQ, Trieu HT, Tran Kim H, Huynh Ngoc Thien V, Huyen VNT, Moncada A, et al. Kinetics of cardiovascular and inflammatory biomarkers in paediatric dengue shock syndrome. Oxf Open Immunol. 2024;5(1):iqae005. (PMID: 10.1093/oxfimm/iqae0053919347411211616); Riviello ED, Kiviri W, Twagirumugabe T, Mueller A, Banner-Goodspeed VM, Officer L, et al. Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali modification of the Berlin definition. Am J Respir Crit Care Med. 2016;193(1):52–9. (PMID: 10.1164/rccm.201503-0584OC26352116); World Health Organization. Dengue: guidelines for diagnosis, treatment, prevention and control. World Health Organization; 2009.; Cui W, Roberson DA. Left ventricular tei index in children: comparison of tissue doppler imaging, pulsed wave doppler, and m-mode echocardiography normal values. J Am Soc Echocardiography [Internet]. 2006;19(12):1438–45. Available from: https://www.sciencedirect.com/science/article/pii/S0894731706006274 .; Ishii M, Eto G, Tei C, Tsutsumi T, Hashino K, Sugahara Y et al. Quantitation of the global right ventricular function in children with normal heart and congenital heart disease: a right ventricular myocardial performance index. Pediatr Cardiol [Internet]. 2000;21(5):416–21. Available from: https://doi.org/10.1007/s002460010100 .; Kirawittaya T, Yoon IK, Wichit S, Green S, Ennis FA, Gibbons RV, et al. Evaluation of cardiac involvement in children with dengue by serial echocardiographic studies. PLoS Negl Trop Dis. 2015;9(7):e0003943. (PMID: 10.1371/journal.pntd.0003943262266584520477); Mahjoub Y, Benoit-Fallet H, Airapetian N, Lorne E, Levrard M, Seydi AA et al. Improvement of left ventricular relaxation as assessed by tissue Doppler imaging in fluid-responsive critically ill septic patients. Intensive Care Med [Internet]. 2012;38(9):1461–70. Available from: https://doi.org/10.1007/s00134-012-2618-9 .; Nagueh SF, Smiseth OA, Appleton CP, Byrd III BF, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiography[Internet]. 2016;29(4):277–314. Available from: https://doi.org/10.1016/j.echo.2016.01.011 .; Desai KV, Laine GA, Stewart RH, Cox CS Jr, Quick CM, Allen SJ, et al. Mechanics of the left ventricular myocardial interstitium: effects of acute and chronic myocardial edema. Am J Physiol Heart Circ Physiol. 2008;294(6):H2428–34. (PMID: 10.1152/ajpheart.00860.200718375722); Miranda CH, Borges M, de Matsuno C, Vilar AK, Gali FC, Volpe LG. Evaluation of cardiac involvement during dengue viral infection. Clin Infect Dis. 2013;57(6):812–9. (PMID: 10.1093/cid/cit40323784923); Nhat PTH, Van Hao N, Tho PV, Kerdegari H, Pisani L, Thu LNM et al. Clinical benefit of AI-assisted lung ultrasound in a resource-limited intensive care unit. Crit Care [Internet]. 2023;27(1):257. Available from: https://doi.org/10.1186/s13054-023-04548-w .; Trieu HT, Khanh LP, Ming DKY, Quang CH, Phan TQ, Van VCN et al. The compensatory reserve index predicts recurrent shock in patients with severe dengue. BMC Med [Internet]. 2022;20(1):109. Available from: https://doi.org/10.1186/s12916-022-02311-6 .; Moulton SL, Mulligan J, Srikiatkhachorn A, Kalayanarooj S, Grudic GZ, Green S et al. State-of-the-art monitoring in treatment of dengue shock syndrome: a case series. J Med Case Rep [Internet]. 2016;10(1):233. Available from: https://pubmed.ncbi.nlm.nih.gov/27553703 .; Trieu HT. Management of dengue shock syndrome: evaluating fluid resuscitation strategies and novel monitoring systems to improve outcomes. University of Oxford; 2022.; Lyle NN, Chanh HQ, Nguyen Van H, Anibal J, Karolcik S, Ming D et al. An artificial intelligence-based approach to identify volume status in patients with severe dengue using wearable PPG data. PLOS Digital Health [Internet]. 2025;4(7):e0000924-. Available from: https://doi.org/10.1371/journal.pdig.0000924 .; Chanh HQ. Investigating cardiovascular and continuous physiological monitoring techniques to improve management of dengue shock syndrome. University of Oxford; 2025. |
| Grant Information: | 1065 Sir Halley Stewart Trust |
| Contributed Indexing: | Keywords: Cardiac function; Dengue; Dengue shock syndrome; Echocardiography; Vascular leakage |
| Entry Date(s): | Date Created: 20260326 Latest Revision: 20260506 |
| Update Code: | 20260506 |
| PubMed Central ID: | PMC13137735 |
| DOI: | 10.1186/s12873-026-01546-3 |
| PMID: | 41882554 |
| Database: | MEDLINE |
Journal Article