Orris

You are saying me to give oil fluids for dengue shock syndrome, but patient is havingascites plural effusion But no bleeding. Hct is 49 Plt 40 k Aptt 50

Reading File
Finding Sources
Finding Sources
Searching PubMed

dengue shock AND fluid management

Searching the Web

WHO dengue shock fluid management ascites pleural effusion hematocrit guidelines

Quick answer

Ascites and pleural effusions in dengue indicate plasma leakage, not that the intravascular circulation is adequately filled. A hematocrit of 49% supports hemoconcentration if it is elevated for that patient. Thus, a patient in true dengue shock may still need IV isotonic crystalloid, but it must be small-volume, closely reassessed resuscitation, not liberal fluids.
  • No bleeding: platelets 40,000 and aPTT 50 seconds alone do not justify platelet, FFP, or blood transfusion. Give blood products only for significant bleeding, or another clear indication.
  • Pleural effusions/ascites: increase the risk of fluid overload, so reassess after every bolus or hourly fluid adjustment.
  • Monitor continuously: BP and pulse pressure, capillary refill, extremity temperature, mental status, urine output, respiratory rate/work of breathing, oxygen saturation, lung exam, serial hematocrit, and bedside ultrasound if available.
  • If shock is compensated, typical dengue protocols use cautious isotonic crystalloid infusion with reassessment at about 1 hour. If hypotensive shock, urgent resuscitation is needed, often with a faster initial crystalloid bolus under senior/ICU supervision.
  • If hematocrit is rising with persistent shock, ongoing leakage is likely and fluids may be needed cautiously.
  • If hematocrit falls with worsening shock, suspect occult bleeding and urgently evaluate for hemorrhage.
  • If respiratory distress, worsening effusions, crackles, rising JVP, or improving perfusion occur, reduce/stop fluids and seek ICU-level management.
This is severe dengue physiology and needs inpatient senior/ICU review now. The key is: treat shock, but avoid over-resuscitation because the leaked fluid is already visible as ascites and pleural effusion.
This is a shared conversation. Sign in to Orris to start your own chat.