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Diagnosis and Treatment

Dengue Clinical Case Management E-learning

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Hematocrit Monitoring

Hematocrit (HCT) monitoring is used to evaluate the degree of plasma leakage and to determine what therapeutic intervention is needed. If a dengue patient has a persistently high HCT, plus  

• Unstable vital signs (particularly narrowing of PP, tachycardia, metabolic acidosis, or poor urine output), this indicates active plasma leakage and the need for further fluid replacement therapy.
• Stable hemodynamic status and adequate urine output, this indicates the patient does not require additional IVFs. Continue to monitor closely and the HCT should start to normalize within the next 24 hours as the plasma leakage stops.

If the dengue patient has a decrease in HCT, plus

• Unstable vital signs, this indicates a major hemorrhage and the urgent need for blood transfusion.
• Stable hemodynamic status and adequate urine output indicates hemodilution due to reabsorption of extravasated fluids. IVFs must be discontinued immediately to avoid fluid overload and pulmonary edema.

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