Evaluation of sublingual microcirculation in children with dengue shock
A 10-year-old male who presented with a 5-day history of fever, abdominal pain, diarrhea, and vomiting. The diagnosis of dengue was made (positive immunoglobulin M serology), and the patient was transferred to the pediatric intensive care unit because of shock during the critical phase (according to the World Health Organization [WHO] classifications) with respiratory distress, altered levels of consciousness, cold and poorly perfused extremities, and anuria.\nThe patient was intubated, mechanically ventilated, resuscitated with 6% hydroxyethyl starch (20 ml/kg) and placed on a dobutamine regimen. Sodium nitroprusside and milrinone were also prescribed because of arterial hypertension and a low cardiac index (<3 L/min/m2), as determined by transesophageal Doppler. Sublingual microcirculation was evaluated after the initial hemodynamic stabilization. ) shows the clinical parameters and medications at the time of analysis. The child was considered without shock on the 6th day of admission.