1University of Miami Miller School of Medicine, Miami, Florida.
2Epidemiology and Population Health Research Group (GESP), School of Public Health, Universidad del Valle, Cali, Colombia.
Am J Trop Med Hyg. 2021 Jan 18;104(3):826-835. doi: 10.4269/ajtmh.20-0103.
To improve dengue triage and treatment decisions, the WHO recommends classifying the disease as dengue with or without warning signs or severe dengue. Vascular leakage is a key component of the pathophysiology of severe dengue and is detectable by ultrasound. The objective of this scoping review is to describe the primary literature on the use of ultrasound in dengue, summarize the findings, and identify knowledge gaps. Our database search retrieved 1,489 records which were reduced to 177 studies following eligibility screening. Descriptive analyses were conducted. Results showed most studies are from South Asia (n = 92, 52%) and assessed hospitalized dengue patients (130, 82%). Radiologists were the most reported ultrasonographers (14, 8%), and conventional ultrasound (39, 68%) was preferred over portable (9, 16%). The most common ultrasound findings in dengue were ascites (107, 60%), pleural effusion (102, 58%), and gallbladder wall thickening (97, 55%). However, the lack of a standard protocol to perform the ultrasound examination in dengue patients hinders conclusions about the frequency of ultrasound findings in dengue. Given the progress of current ultrasound technology, a focused point-of-care ultrasound protocol for early detection of vascular leakage in dengue is needed to generate the evidence required for its implementation in routine care.
为了改善登革热分诊和治疗决策，世卫组织建议将该疾病分为有或无警告症状或重症登革热。血管渗漏是重症登革热病理生理学的一个关键组成部分，可以通过超声检测到。本范围综述的目的是描述关于在登革热中使用超声的主要文献，总结研究结果并确定知识空白。我们的数据库检索共检索到 1489 条记录，经过资格筛选后，将其减少到 177 项研究。进行了描述性分析。结果表明，大多数研究来自南亚（n=92，52%），并评估了住院登革热患者（n=130，82%）。放射科医生是报告最多的超声医师（n=14，8%），常规超声（n=39，68%）优于便携式超声（n=9，16%）。登革热中最常见的超声表现为腹水（n=107，60%）、胸腔积液（n=102，58%）和胆囊壁增厚（n=97，55%）。然而，由于缺乏在登革热患者中进行超声检查的标准方案，难以对登革热患者中超声表现的频率得出结论。鉴于当前超声技术的进步，需要制定一个侧重于即时护理的超声协议，以早期发现登革热中的血管渗漏，从而为其在常规护理中的实施提供所需的证据。
