RESPONSE TO COMMENTS
Year : 2017 | Volume
: 61 | Issue : 6 | Page : 526-
Can fluid resuscitation be a risk factor for laryngeal oedema in severe dengue?
Sai Saran, Afzal Azim
Department of Critical Care Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
Department of Critical Care Medicine, SGPGIMS, Lucknow - 226 014, Uttar Pradesh
|How to cite this article:|
Saran S, Azim A. Can fluid resuscitation be a risk factor for laryngeal oedema in severe dengue?.Indian J Anaesth 2017;61:526-526
|How to cite this URL:|
Saran S, Azim A. Can fluid resuscitation be a risk factor for laryngeal oedema in severe dengue?. Indian J Anaesth [serial online] 2017 [cited 2020 Jun 2 ];61:526-526
Available from: http://www.ijaweb.org/text.asp?2017/61/6/526/207765
We sincerely thank the authors for their questions. We accept that bleeding in respiratory tract can be a complication of severe dengue, but it did not occur in our illustrated case. It is difficult to point to a single factor that is responsible, as the disease manifests with multi-organ involvement. We suggest fluid resuscitation as an additional risk factor which is rarely discussed in the literature on severe dengue, where there is capillary leakage and severe inflammatory response accompanied by slow resolution as compared to mild dengue. We stress that intravenous fluids should be “prescribed” only in the critical phase of dengue manifested by a rise in the haematocrit rising of 10%–20% or thrombocytopenia with features of dengue shock syndrome. Daily fluid balance should be monitored after which fluids have to be restricted. We suggest that fluid removal may also be required after this phase is over as described in the four phases of fluid resuscitation (rescue, optimisation, stabilisation and de-escalation) to prevent any complications of fluid overload.
We sincerely acknowledge the patient for giving consent and allowing us to write this case report.
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Conflicts of interest
There are no conflicts of interest.
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