To identify the role of haemoglobin, pack cell volume and puise pressure in predicting fluid leakage in patients with dengue who consume adequate amounts of fluids

Abstract

INTRODUCTION: Early detection of fluid leakage is important in identifying patients who are likely to develop shock syndrome in dengue. As patients are advised to consume adequate amounts of fluids such behaviours may alter the clinical and haematological parameters predicting fluid leakage. Methods: fn 102 confirmed dengue patients admitted to a single medical unit, CNTH, Ragama from September 2011,quantity and quality of fluids consumed, Hb, PCV, pulse pressure(PP) and their percentage rise or decline were documented and compared between those who developed and did not develop third space fluid accumulation(TSFA) [either pieural effusions, ascites or both detected by ultrasonography]. RESULTS: In 102 patients (52 males) with mean age 28.3(SD=11.8) years, TSFA was detected in 34/95(37%) on follow up. fn those who developed TSFA and did not develop TSFA, average consumption of water 620cc/day vs 491cc/day fp=0.14); solutes 1461cc/day vs 1481cc/day (p=0.83); the mean(SD) values of highest Hb 14.66(1.82)g/dl vs 14.28(1.6)g/dl (p=0.3) and highest PCV 44.16 (5.19) vs 43.4 (4.5) 0=0.46); pulse pressure 29.9mmHg vs 28.4 0=0.29); The maximum percentage rise in Hb 8%vs 4.6% (p=0.02); PCV 8.6% vs 4.5% 0=0-006); mean pulse pressure drop 6.9% vs 5.9% 0=0.84). Conclusions: In the presence of fluid consumption the quality or quantity of fluids consumed did not seems to contribute to TSFA. A single value of Hb, PCV or pulse pressure was not helpful in predicting early fluid leakage. While percentage reduction in pulse pressure was not helpful, percentage rise in Hb and PCV remained predictive of early fluid leakage in dengue.