LAUSR

liver and oliguria. Laboratory features of increase in Hematocrit (HCT) and decrease in platelet counts are important to recognize. Other uncommon manifestations are hepatic failure, myocarditis, and encephalopathy. At times these might be severe and may occur with minimal features of increased 2,3 capillary permeability. Exact management plan varies according to the needs of the patient. However certain basic principles must be kept in mind. Fluid management Close attention to fluid balance is important. Unnecessary fluid administration based only on Hematocrit (HCT) level without consideration of c l in ical condit ion, prolonged f ixed f lu id administration without varying the dose according to the rate of plasma leak and continuous intravenous fluid during convalescent phase should 4 be avoided. Patients in critical phase without shock In hemodynamically stable patients, in the absence of vomiting; oral fluid administration is sufficient. Intravenous fluids are needed if there is increase in HCT which indicates ongoing capillary leakage, or presence of persistent vomiting or intolerance to oral 4 fluids. Dengue shock syndrome (DSS): Compensated and decompensated It is a medical emergency. Early diagnosis and administration of fluid to replace leakage is important step and ensures a good prognosis. Disease outcomes becomes less certain with progression to a decompensated state. Pulse Introduction Dengue (Break bone) fever is one of the rapidly emerging infectious diseases across the globe. Pakistan has also experienced huge outbreaks 1 affecting thousands of people. Dengue, an arthropod borne virus affects individuals from all age groups. It is mainly spread by mosquitoes Aedes aegypti and Aedes Albopictus during rainy season. As there is no effective anti-viral drug available, case detection, management and vector control are main strategies for its prevention and control. This review will mainly focus on principles of treatment of critically ill adult patients especially in the first 24-48 hours. Management In early phase it is important to recognize clinical and laboratory features of plasma leakage and c i rc u l ato r y s h o c k . ' Re d f l a g ' s i g n s a re pain/tenderness in abdomen along with persistent vomiting, clinical signs of fluid in pleural/peritoneal cavity, bleeding manifestations, an enlarged tender Dengue Fever: In-Hospital Management of Critically ill Adult Patients 1 2 Aamir Shahzad , Kiran Fatima