Recommendations for the Management of Severe Pediatric Dengue: Pediatric Chapter – Pediatric Shock Committee

Abstract

Introduction: In 2024, dengue affected most of the health jurisdictions in Argentina. The epidemic generated consultations on documents on case management. The Shock Committee of the Argentine Society of Intensive Care Medicine observed that the bibliography regarding the management of severe dengue cases in Pediatric Intensive Care Units was scarce and based mainly on global documents older than 10 years.

Objective: To make a national recommendation updating the information of international consensus, with the collaboration of representatives of other countries in the region, regarding the management of severe pediatric dengue in Argentina. It is not intended to replace the practice guidelines established by the Ministry of Health of the Nation.

Design: A panel was formed consisting of 11 pediatric intensivists from Argentina, 3 international experts related to the Argentine context (2 pediatric intensivists -Bolivia and Paraguay/, 1 pediatric emergency specialist -Paraguay-) and 1 infectious disease specialist expert in dengue.

The experts were organized into groups, each coordinated by a member. Each group developed a proposal of recommendations on epidemiology, clinical, general management and specific management of severe pediatric dengue.

Methods: A proposal was developed and agreements were made through numerous virtual meetings where they were discussed. The coordinating team gathered all the proposals and suggested the changes that iteratively led to the creation of the final document

Result: At the end of 2 months of work, the group provided recommendations regarding the initial triage and updated management of severe pediatric dengue and the pertinent points of its management in Pediatric Intensive Care Units.

Conclusions: Since the launch of the guidelines for the diagnosis and treatment of severe dengue in Argentina, this is the first time that a group of experts has developed guidelines for Pediatric Intensive Care Units.