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State-of-the-art monitoring in treatment of dengue shock syndrome: a case series
BACKGROUND: Early recognition and treatment of circulatory volume loss is essential in the clinical management of dengue viral infection. We hypothesized that a novel computational algorithm, originally developed for noninvasive monitoring of blood loss in combat casualties, could: (1) indicate the...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995799/ https://www.ncbi.nlm.nih.gov/pubmed/27553703 http://dx.doi.org/10.1186/s13256-016-1019-z |
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author | Moulton, Steven L. Mulligan, Jane Srikiatkhachorn, Anon Kalayanarooj, Siripen Grudic, Greg Z. Green, Sharone Gibbons, Robert V. Muniz, Gary W. Hinojosa-Laborde, Carmen Rothman, Alan L. Thomas, Stephen J. Convertino, Victor A. |
author_facet | Moulton, Steven L. Mulligan, Jane Srikiatkhachorn, Anon Kalayanarooj, Siripen Grudic, Greg Z. Green, Sharone Gibbons, Robert V. Muniz, Gary W. Hinojosa-Laborde, Carmen Rothman, Alan L. Thomas, Stephen J. Convertino, Victor A. |
author_sort | Moulton, Steven L. |
collection | PubMed |
description | BACKGROUND: Early recognition and treatment of circulatory volume loss is essential in the clinical management of dengue viral infection. We hypothesized that a novel computational algorithm, originally developed for noninvasive monitoring of blood loss in combat casualties, could: (1) indicate the central volume status of children with dengue during the early stages of “shock”; and (2) track fluid resuscitation status. METHODS: Continuous noninvasive photoplethysmographic waveforms were collected over a 5-month period from three children of Thai ethnicity with clinical suspicion of dengue. Waveform data were processed by the algorithm to calculate each child’s Compensatory Reserve Index, where 1 represents supine normovolemia and 0 represents the circulatory volume at which hemodynamic decompensation occurs. Values between 1 and 0 indicate the proportion of reserve remaining before hemodynamic decompensation. RESULTS: This case report describes a 7-year-old Thai boy, another 7-year-old Thai boy, and a 9-year-old Thai boy who exhibited signs and symptoms of dengue shock syndrome; all the children had secondary dengue virus infections, documented by serology and reverse transcriptase polymerase chain reaction. The three boys experienced substantial plasma leakage demonstrated by pleural effusion index >25, ascites, and >20 % hemoconcentration. They received fluid administered intravenously; one received a blood transfusion. All three boys showed a significantly low initial Compensatory Reserve Index (≥0.20), indicating a clinical diagnosis of “near shock”. Following 5 days with fluid resuscitation treatment, their Compensatory Reserve Index increased towards “normovolemia” (that is, Compensatory Reserve Index >0.75). CONCLUSIONS: The results from these cases demonstrate a new variation in the diagnostic capability to manage patients with dengue shock syndrome. The findings shed new light on a method that can avoid possible adverse effects of shock by noninvasive measurement of a patient’s compensatory reserve rather than standard vital signs or invasive diagnostic methods. |
format | Online Article Text |
id | pubmed-4995799 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49957992016-08-25 State-of-the-art monitoring in treatment of dengue shock syndrome: a case series Moulton, Steven L. Mulligan, Jane Srikiatkhachorn, Anon Kalayanarooj, Siripen Grudic, Greg Z. Green, Sharone Gibbons, Robert V. Muniz, Gary W. Hinojosa-Laborde, Carmen Rothman, Alan L. Thomas, Stephen J. Convertino, Victor A. J Med Case Rep Research Article BACKGROUND: Early recognition and treatment of circulatory volume loss is essential in the clinical management of dengue viral infection. We hypothesized that a novel computational algorithm, originally developed for noninvasive monitoring of blood loss in combat casualties, could: (1) indicate the central volume status of children with dengue during the early stages of “shock”; and (2) track fluid resuscitation status. METHODS: Continuous noninvasive photoplethysmographic waveforms were collected over a 5-month period from three children of Thai ethnicity with clinical suspicion of dengue. Waveform data were processed by the algorithm to calculate each child’s Compensatory Reserve Index, where 1 represents supine normovolemia and 0 represents the circulatory volume at which hemodynamic decompensation occurs. Values between 1 and 0 indicate the proportion of reserve remaining before hemodynamic decompensation. RESULTS: This case report describes a 7-year-old Thai boy, another 7-year-old Thai boy, and a 9-year-old Thai boy who exhibited signs and symptoms of dengue shock syndrome; all the children had secondary dengue virus infections, documented by serology and reverse transcriptase polymerase chain reaction. The three boys experienced substantial plasma leakage demonstrated by pleural effusion index >25, ascites, and >20 % hemoconcentration. They received fluid administered intravenously; one received a blood transfusion. All three boys showed a significantly low initial Compensatory Reserve Index (≥0.20), indicating a clinical diagnosis of “near shock”. Following 5 days with fluid resuscitation treatment, their Compensatory Reserve Index increased towards “normovolemia” (that is, Compensatory Reserve Index >0.75). CONCLUSIONS: The results from these cases demonstrate a new variation in the diagnostic capability to manage patients with dengue shock syndrome. The findings shed new light on a method that can avoid possible adverse effects of shock by noninvasive measurement of a patient’s compensatory reserve rather than standard vital signs or invasive diagnostic methods. BioMed Central 2016-08-24 /pmc/articles/PMC4995799/ /pubmed/27553703 http://dx.doi.org/10.1186/s13256-016-1019-z Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Moulton, Steven L. Mulligan, Jane Srikiatkhachorn, Anon Kalayanarooj, Siripen Grudic, Greg Z. Green, Sharone Gibbons, Robert V. Muniz, Gary W. Hinojosa-Laborde, Carmen Rothman, Alan L. Thomas, Stephen J. Convertino, Victor A. State-of-the-art monitoring in treatment of dengue shock syndrome: a case series |
title | State-of-the-art monitoring in treatment of dengue shock syndrome: a case series |
title_full | State-of-the-art monitoring in treatment of dengue shock syndrome: a case series |
title_fullStr | State-of-the-art monitoring in treatment of dengue shock syndrome: a case series |
title_full_unstemmed | State-of-the-art monitoring in treatment of dengue shock syndrome: a case series |
title_short | State-of-the-art monitoring in treatment of dengue shock syndrome: a case series |
title_sort | state-of-the-art monitoring in treatment of dengue shock syndrome: a case series |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995799/ https://www.ncbi.nlm.nih.gov/pubmed/27553703 http://dx.doi.org/10.1186/s13256-016-1019-z |
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