登革热的输液管理--来自病床的启示

Krishnatha Jayasekera
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摘要

登革热是一种通过蚊子传播的热带流行性病毒性疾病,给东南亚地区的医疗保健系统造成了沉重负担。尽管病例密度逐年增加,但斯里兰卡的死亡率却呈明显下降趋势。严重登革热的病理生理特征是血浆渗漏,可能导致休克和器官衰竭等危及生命的并发症。临床护理的关键环节包括早期识别预警信号、监测临床参数以及根据患者的不同需求调整液体疗法。优化输液管理对于降低与严重登革热感染相关的发病率和死亡率至关重要。输液管理的关键决策要因人而异,密切监测生命参数。根据床旁临床和超声评估结果,确定输液量和输液类型,以维持足够的血流灌注,同时防止液体超负荷。本病例讨论概述了目前在登革热不同临床阶段的输液管理策略,强调了在管理复杂登革热患者时可能出现的常见误区。最重要的是,我们要深入了解登革热危重阶段的合理输液管理,以最大限度地降低发病率和死亡率。孟加拉国医学杂志》,2024 年;第 35 卷,第 2 期,增刊:130-131
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fluid Management in Dengue -Insights from Bedside
Dengue fever, a prevalent tropical viral illness transmitted by mosquitoes, poses a substantial burden on healthcare systems in Southeast Asia. Despite the increase in case density annually there is a noticeable downward trend in mortality rates in Sri Lanka. The pathophysiological hallmark of severe dengue is plasma leakage, leading to potentially life-threatening complications such as shock and organ failure. Key aspects of clinical care include early recognition of warning signs, monitoring of clinical parameters, and tailoring fluid therapy to individual patient needs. Optimizing fluid management is essential for reducing morbidity and mortality associated with severe dengue infection. Key decisions on fluid management are individualized with intense monitoring of vital parameters. The amount and type of fluid administered to maintain adequate perfusion while preventing fluid overload are based on the bed side clinical and sonographic assessment. This case-based discussion provides an overview of current fluid management strategies in various clinical stages of dengue highlighting the common pitfalls that may arise during management of complicated dengue patients. It is of utmost importance that we acquire the insight into the judicious fluid management during critical phase of dengue to minimize morbidity and mortality.  Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 130-131
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