علاج حمى الضنك مع علامات التحذير أو الأمراض المصاحبة عالية الخطورة: نقص التروية وارتفاع الهيماتوكريت

References

1. The dengue patients with warning signs and high-risk groups are considered to be as moderately ill and classified as Group B.
2. Includes dengue with warning signs or all special populations.
3. Grade B with warning signs in adults (systolic pressure maintained + signs of reduced perfusion), HCT high.
4. Isotonic fluid: 0.9% NS or RL are preferred.
5. Start isotonic crystalloid 5–10 mL/kg/h for 1 h.
6. Start fluid at 5–7 mL/kg/h for 1–2 h reducing to 3–5 mL/kg/h for 2–4 h and then reduce to 2–3 mL/kg/h or less according to the clinical response.
7. IV crystalloid, reduce gradually 3–5 mL/kg/h for 2–4 h · 2–3 mL/kg/h for 2–4 h · 1.5 mL/kg/h for 2–4 h.
8. Stop IV fluids at 24–48 h.
9. Improvement: BP improved, pulse pressure improved, HCT decreased, urine output improved, capillary refilling.
10. Adequate intravenous fluid volume may be required to maintain good perfusion and urine output of about 0.5 mL/kg/h.