Evidence behind the WHO Guidelines: Hospital Care for Children: What Treatments are Effective for the Management of Shock in Severe Dengue?
Bibliographic record
Abstract
The World Health Organization has produced guidelines for the management of common illnesses in hospitals with limited resources. This series reviews the scientific evidence behind WHO's recommendations. The WHO guidelines, and more reviews are available at http://www.ichrc.org This review addresses the question: What treatments are effective for the management of shock in severe dengue? The WHO Pocketbook of Hospital Care for Children recommends to give only isotonic solutions such as Ringer's lactate, Hartmann's solution or 5% glucose in Ringer's lactate. Patients in shock (pulse pressure <20 mmHg) should be given 20 ml/kg of isotonic fluid >1 h. If response occurs, then the rate of fluid is reduced accordingly. If no response, then a repeat bolus of isotonic fluid is recommended and consideration of 6% dextran or 6% HES 10–15 ml/kg >1 h is advised. Transfusions are rarely necessary and should be only given with extreme care due to fluid overload. Platelet transfusions should only be given for severe bleeding. Diuretics should be avoided in the case of fluid overload unless the shock has resolved. Steroids are not recommended. (Pocketbook section 6.10).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.004 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".