حمى الضنك الشديدة مع صدمة تعويضية (عميقة) ومتوسط الضغط الشرياني أقل من 65 ملم زئبق

References

• Decompensated shock among adults (hypotension + signs of reduced perfusion) mean arterial pressure (MAP) < 65, HCT high
• Table 9. Treatment of profound shock (hypotensive; undetectable pulse and BP)
• Intravenous 10–20 mL/kg of bolus fluid should be given as fast as possible, ideally within 10–15 minutes.
• Measure HCT 1 then Ringer lactate or Crystalloid (if pulse pressure < 10 mmHg or severe hypotension) IV or IO: Children and adults: 20 mL/kg in 15–30 min (1st bolus)
• Start isotonic crystalloid 10–20 mL/kg for 20–30 min as bolus
• IV crystalloid, reduce gradually 5–7 mL/kg/h for 1–2 h, 3–5 mL/kg/h for 2–4 h, 2–3 mL/kg/h for 2–4 h
• Improvement BP improved, pulse pressure improved, HCT decreased, urine output improved, capillary refilling time improved, pulse rate normal