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Dengue Hemorrhagic Fever Management

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DJ CrissCross
DJ CrissCross

Dengue Hemorrhagic Fever Management

Saúde e medicina
1 de 74
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999
[object Object],[object Object],[object Object],[object Object],[object Object],Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999
Tourniquet Test ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999
Grading the Severity of Dengue Infection Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999 DF / DHF Grade Symptoms Labs DF Fever with two or more of the ff: headache, retro-orbital pain, myalgia, arthralgia Leukopenia Thrombocytopenia < 100,000 No evidence of plasma loss DHF I Above signs plus positive tourniquet test Thrombocytopenia <100,000 Hct rise >20% DHF II Above signs plus spontaneous bleeding Thrombocytopenia <100,000 Hct rise >20% DHF III Above signs plus circulatory failure (weak pulse, hypotension restlessness) Thrombocytopenia <100,000 Hct rise >20% DHF IV Profound shock with undetectable blood pressure and pulse Thrombocytopenia <100,000 Hct rise >20%
Criteria For Hospitalization ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Criteria For Hospitalization ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GENERAL MANAGEMENT OF DENGUE ,[object Object],[object Object],[object Object],[object Object],[object Object],Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999
Treatment Of Dengue with hemorrhage & shock ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],FLUID RESUSCITATION
Fluids Required for Intravenous Therapy ,[object Object],[object Object],[object Object],[object Object],Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999
Fluids Required for Intravenous Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
DRAWBACK IN THE USE OF COLLOIDS: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Advantages of Crystalloids: ,[object Object],[object Object],[object Object]
Studies on the Different Fluid Regimen in the Initial Resuscitation of DSS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Acute Management of DSS: A Randomized, Double blind Comparison of Four Intravenous Fluid Regimens in the First Hour by: Nhan NT, Phuong CX, et al Clinical Infectious Disease 2001: 32: 204 – 213
Acute Management of DSS: A Randomized, Double blind Comparison of Four Intravenous Fluid Regimens in the First Hour by: Nhan NT, Phuong CX, et al Clinical Infectious Disease 2001: 32: 204 – 213 ,[object Object],[object Object]
Acute Management of DSS: A Randomized, Double blind Comparison of Four Intravenous Fluid Regimens in the First Hour by: Nhan NT, Phuong CX, et al Clinical Infectious Disease 2001: 32: 204 – 213 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],Acute Management of DSS: A Randomized, Double blind Comparison of Four Intravenous Fluid Regimens in the First Hour by: Nhan NT, Phuong CX, et al Clinical Infectious Disease 2001: 32: 204 – 213
[object Object],[object Object],[object Object],Acute Management of DSS: A Randomized, Double blind Comparison of Four Intravenous Fluid Regimens in the First Hour by: Nhan NT, Phuong CX, et al Clinical Infectious Disease 2001: 32: 204 – 213
[object Object],[object Object],[object Object],[object Object],Acute Management of DSS: A Randomized, Double blind Comparison of Four Intravenous Fluid Regimens in the First Hour by: Nhan NT, Phuong CX, et al Clinical Infectious Disease 2001: 32: 204 – 213
[object Object],[object Object],Comparison of Three Fluid Solutions for Resuscitation in DSS by: Wills B, Nguyen M. Dung, et al New England Journal Of Medicine, Sept 2005: 353, No 9:877-889
Comparison of Three Fluid Solutions for Resuscitation in DSS by: Wills B, Nguyen M. Dung, et al New England Journal Of Medicine, Sept 2005: 353,No 9:877-889 ,[object Object],[object Object],[object Object]
Comparison of Three Fluid Solutions for Resuscitation in DSS by: Wills B, Nguyen M. Dung, et al New England Journal Of Medicine, Sept 2005: 353, No 9:877-889 ,[object Object],[object Object],[object Object]
Comparison of Three Fluid Solutions for Resuscitation in DSS by: Wills B, Nguyen M. Dung, et al New England Journal Of Medicine, Sept 2005: 353,No 9:877-889 ,[object Object],[object Object],[object Object]
Comparison of Three Fluid Solutions for Resuscitation in DSS by: Wills B, Nguyen M. Dung, et al New England Journal Of Medicine, Sept 2005: 353,No 9:877-889 ,[object Object],[object Object],[object Object],[object Object]
Comparison of Three Fluid Solutions for Resuscitation in DSS by: Wills B, Nguyen M. Dung, et al New England Journal Of Medicine, Sept 2005: 353,No 9:877-889 ,[object Object],[object Object]
Comparison of Three Fluid Solutions for Resuscitation in DSS by: Wills B, Nguyen M. Dung, et al New England Journal Of Medicine, Sept 2005: 353, No 9: 877-889 ,[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object],[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 ,[object Object],[object Object],[object Object]
Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 W group P group Mean time of death (days) 1.4 4.5 Mortality Rate 22% 7% # of patients dying within 24 hours of admission to the ICU 13 out of 19 2 out 6 Causes of death 7 - Refractory shock 10 - MODS (ARDS and DIC) 2 - Fulminant hepatic failure 5 – Refractory shock 1 - Fulminant hepatic failure
[object Object]
Indications For Blood Products in Dengue Infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Protrombin & Partial Thromboplastin Time as a Predictor of Bleeding in Patients w/ patients with DHF Chua MN, Molanida R, et al South East Asian Journal Tropical Medicine & Public Health,1993; 24(1): 141-143
Protrombin & Partial Thromboplastin Time as a Predictor of Bleeding in Patients w/ patients with DHF Chua MN, Molanida R, et al South East Asian Journal Tropical Medicine & Public Health,1993; 24(1): 141-143 ,[object Object],[object Object],[object Object],[object Object]
Preventive transfusion in Dengue shock syndrome- is it necessary? Lum LC, Abdel-Latif Mel A, Goh AY. Chan PW, Lam SK (2003). J Pediatr, 143(5), Sep, pp 682-4 ,[object Object],[object Object],        
Preventive transfusion in Dengue shock syndrome- is it necessary? Lum LC, Abdel-Latif Mel A, Goh AY. Chan PW, Lam SK (2003). J Pediatr, 143(5), Sep, pp 682-4 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Role of platelet transfusion in dengue hemorrhagic fever Kabra SK, Jain Y,Madhulika et al Indian Pediatr 1998; 35 : 452-454. ,[object Object],[object Object],[object Object]
Thrombocytopenia & Platelet transfusion in DHF & DSS Alex Chairulfatah, Setiabudi D, et al Institute of Tropical Medicine, Belgium, 1995; 75 (4) : 291-295 ,[object Object],[object Object]
Thrombocytopenia & Platelet transfusion in DHF & DSS Alex Chairulfatah, Setiabudi D, et al Institute of Tropical Medicine, Belgium, 1995; 75 (4) : 291-295 ,[object Object],[object Object]
[object Object],[object Object],Clinical Practice Guidelines, Dengue Infection in Adults Dengue Consensus 2003, Academy of Medicine Malaysia Ministry of Health
RECOMBINANT ACTIVATED FACTOR ( rFV11a )
Recombinant Activated Factor VII ( rFVIIa ) ,[object Object],[object Object]
Control of bleeding in children with Dengue Hemorrhagic Fever using Recombinant activated Factor VII: A Randomized, Double-blind, Placebo-controlled Study Ampaiwan Chuansumrita, Somporn Wangruangsatidb, et al Blood Coagulation and Fibrinolysis 2005, Vol 16 No 8, 549–555 ,[object Object],[object Object]
Control of bleeding in children with Dengue Hemorrhagic Fever using Recombinant activated Factor VII: A Randomized, Double-blind, Placebo-controlled Study Ampaiwan Chuansumrita, Somporn Wangruangsatidb, et al Blood Coagulation and Fibrinolysis 2005, Vol 16 No 8, 549–555 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Control of bleeding in children with Dengue Hemorrhagic Fever using Recombinant activated Factor VII: A Randomized, Double-blind, Placebo-controlled Study Ampaiwan Chuansumrita, Somporn Wangruangsatidb, et al Blood Coagulation and Fibrinolysis 2005, Vol 16 No 8, 549–555 ,[object Object],[object Object]
Control of bleeding in children with Dengue Hemorrhagic Fever using Recombinant activated Factor VII: A Randomized, Double-blind, Placebo-controlled Study Ampaiwan Chuansumrita, Somporn Wangruangsatidb, et al Blood Coagulation and Fibrinolysis 2005, Vol 16 No 8, 549–555 ,[object Object],[object Object]
Control of bleeding in children with Dengue Hemorrhagic Fever using Recombinant activated Factor VII: A Randomized, Double-blind, Placebo-controlled Study Ampaiwan Chuansumrita, Somporn Wangruangsatidb, et al Blood Coagulation and Fibrinolysis 2005, Vol 16 No 8, 549–555 ,[object Object]
Control of bleeding in children with Dengue Hemorrhagic Fever using Recombinant activated Factor VII: A Randomized, Double-blind, Placebo-controlled Study Ampaiwan Chuansumrita, Somporn Wangruangsatidb, et al Blood Coagulation and Fibrinolysis 2005, Vol 16 No 8, 549–555 ,[object Object]
The use of recombinant activated factor VII for controlling life-threatening bleeding in Dengue Shock Syndrome Ampaiwan Chuansumrita, Kanchana Tangnararatchakita, et al Blood Coagulation and Fibrinolysis 2004, 15:335–342 ,[object Object],[object Object]
The use of recombinant activated factor VII for controlling life-threatening bleeding in Dengue Shock Syndrome Ampaiwan Chuansumrita, Kanchana Tangnararatchakita, et al Blood Coagulation and Fibrinolysis 2004, 15:335–342 ,[object Object]
The use of recombinant activated factor VII for controlling life-threatening bleeding in Dengue Shock Syndrome Ampaiwan Chuansumrita, Kanchana Tangnararatchakita, et al Blood Coagulation and Fibrinolysis 2004, 15:335–342 ,[object Object],[object Object]
OXYGEN THERAPY
[object Object],[object Object],[object Object],[object Object]
ROLE OF IV Ig
The use of intravenous gammaglobulin in dengue fever, a case report. Ascher DP , Laws HF , Hayes CG . Department of Pediatrics, 13th Air Force Medical Center, Manila, Phil Southeast Asian J Trop Med Public Health. 1989 Dec;20(4):549-54. ,[object Object],[object Object],[object Object]
ROLE OF STEROIDS
Studies on the Role of Steroids in Dengue Shock Syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DENGUE VACCINE
Recommendations of the Scientific Working Group on Dengue (2000) ,[object Object],[object Object],[object Object]
Is dengue vaccine possible? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Dengue Vaccines ,[object Object],[object Object],[object Object],[object Object],[object Object]
Dengue Vaccines ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]

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Dengue Hemorrhagic Fever Management

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  • 7. Grading the Severity of Dengue Infection Guidelines for Treatment of DF/ DHF in Small Hospitals WHO, New Delhi, 1999 DF / DHF Grade Symptoms Labs DF Fever with two or more of the ff: headache, retro-orbital pain, myalgia, arthralgia Leukopenia Thrombocytopenia < 100,000 No evidence of plasma loss DHF I Above signs plus positive tourniquet test Thrombocytopenia <100,000 Hct rise >20% DHF II Above signs plus spontaneous bleeding Thrombocytopenia <100,000 Hct rise >20% DHF III Above signs plus circulatory failure (weak pulse, hypotension restlessness) Thrombocytopenia <100,000 Hct rise >20% DHF IV Profound shock with undetectable blood pressure and pulse Thrombocytopenia <100,000 Hct rise >20%
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  • 40. Aggressive Management of Dengue Shock Syndrome May Decrease Mortality Rate : A Suggested Protocol by: Ranjit Suchitra, Kissoon Niranjan, Jayakumar Indira Pediatric Critical Care Medicine, Vol 6 (4), July 2005, 412 - 419 W group P group Mean time of death (days) 1.4 4.5 Mortality Rate 22% 7% # of patients dying within 24 hours of admission to the ICU 13 out of 19 2 out 6 Causes of death 7 - Refractory shock 10 - MODS (ARDS and DIC) 2 - Fulminant hepatic failure 5 – Refractory shock 1 - Fulminant hepatic failure
  • 41.
  • 42.
  • 43. Protrombin & Partial Thromboplastin Time as a Predictor of Bleeding in Patients w/ patients with DHF Chua MN, Molanida R, et al South East Asian Journal Tropical Medicine & Public Health,1993; 24(1): 141-143
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  • 51. RECOMBINANT ACTIVATED FACTOR ( rFV11a )
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  • 64. ROLE OF IV Ig
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  • 66. ROLE OF STEROIDS
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