Treatment of adults with severe dengue patients in Thailand

Key measures for improving the survival rate in dengue shock patients are an early and appropriate diagnosis and treatment together with close monitoring by early provision of appropriate types, rates, objectives, and limits (TROLs) of fluid therapies, especially in the critical phase of the disease. The hemodynamic assessments to guide fluid resuscitation should mainly rely on clinical signs, hematocrit along with non-invasive monitoring tools. These concepts aim to maintain adequate oxygen delivery to the vital organs, to prevent a prolonged shock stage and subsequent organ failures. Diagnosis and treatment for poor tissue perfusion should be initiated as early as possible from the onset of the cytokine cascade-induced plasma leakage and disruption of the glycocalyx layer of the vascular endothelial cells.