# Role of Hemoperfusion With HA330 in the Management of Severe Dengue Shock Syndrome

## TL;DR

This study explores using hemoperfusion with hemoadsorption and other treatments to reduce inflammation and improve outcomes in children with severe dengue shock syndrome.

## Contribution

The study introduces a novel combination therapy for managing dengue-induced hemophagocytic syndrome in pediatric patients.

## Key findings

- Inflammatory markers like ferritin and IL-6 significantly decreased after the intervention.
- Hemodynamic stability improved as shown by reduced PELOD-2 and VIS scores.
- No adverse effects were observed with the combined therapy.

## Abstract

Infection‐associated hemophagocytic syndrome (IAHS) is a rare complication in dengue infection that leads to multiple organ dysfunction (MOD) and increased mortality rates. The early use of hemoperfusion with hemoadsorption and standard treatment may reduce inflammation and prevent mortality. This study investigates the therapeutic effectiveness of a combination of hemoperfusion with hemoadsorption and multimodal therapy, including intravenous immunoglobulin (IVIG), corticosteroids, therapeutic plasma exchange (TPE), and/or extracorporeal organ support in pediatric patients with MOD and IAHS resulting from dengue shock syndrome (DSS).

This retrospective observational research includes MOD and IAHS resulting from DSS. All children had 4 h of hemoperfusion with hemoadsorption for a duration of 1–3 consecutive days, accompanied by multimodal therapy. Inflammatory markers and mortality rates were assessed.

Five patients were included. All patients received hemoperfusion with hemoadsorption combined with CRRT, while four out of five patients received IVIG, dexamethasone, and plasmapheresis. The median PELOD‐2 and vasoactive‐inotropic score (VIS) decreased postintervention (8.0 vs. 6.0 and 20.0 vs. 10.0). The median log10 serum ferritin (5.000 vs. 4.724 ng/mL, p value < 0.05) and log10 serum IL‐6 (3.193 vs. 2.018 pg/mL, p value < 0.05) levels of the biomarker were significantly decreased. No additional adverse effects were noted.

The combination of hemoperfusion with hemoadsorption and multimodal therapy effectively reduced inflammatory biomarkers and enhanced hemodynamic stability. Nevertheless, mortality outcomes should be assessed across larger populations.