Abstract
Objectives: Dengue remains a serious global health concern, with substantial morbidity and mortality. However, there is a lack of objective evidence regarding the amount and type of fluid required for resuscitation, which is the cornerstone of dengue management. Thromboelastogram (TEG) parameters have been observed to be affected in dengue; however, there has been limited research investigating the real-time changes in TEG parameters related to fluid resuscitation. This study aimed to assess TEG changes after fluid resuscitation in dengue to enhance understanding of the pathophysiology and refine management strategies.
Design: This was a prospective observational study with no intervention in the patient’s diagnosis and management.
Setting: Department of Emergency Medicine, Hospital Sungai Buloh, Malaysia.
Patients and participants: 20 participants diagnosed with dengue underwent TEG assessment pre- and 1 hour after fluid resuscitation. Standardized clinical and laboratory data were collected, including vital signs, hematological parameters, coagulation profiles, and TEG parameters.
Results: TEG parameters, specifically alpha angle and maximum amplitude, exhibited significant reductions post-resuscitation in dengue warning signs (p=0.019 and p=0.04). These findings suggest a potential link between fluid resuscitation and altered coagulation dynamics.
Conclusion: This study offers insights into TEG changes post-fluid resuscitation, highlighting potential implications for glycocalyx disruption. Future research, including larger cohorts and exploration of different fluid types, is crucial for a comprehensive understanding of dengue pathophysiology and refining fluid resuscitation strategies.
Mohamad Iqhbal Bin Kunji Mohamad, Sabariah Faizah Jamaluddin, Roslanuddin Bin Mohd Salehuddin, Rossman Bin Hawari
