The Importance Of Hemodynamic Monitoring

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Recently, hemodynamic monitoring is a functional tool used for assessing pathophysiological process of the diseases with the aims to alert the health care team to aware of impending cardiovascular crisis before the development of organ injury [15]. In addition, it can be used to facilitate diagnosis leading to provide effective management and to monitor response to therapy [15, 16]. The appropriate modality of hemodynamic monitoring depends on factors including availability of the monitoring technique in the institution, accuracy of the device and patient’s condition with contraindications. As patients with dengue has potential risk for bleeding, non-invasive hemodynamic monitor should be considered for a serial assessment in order to…show more content…
Laboratory findings among patients with dengue shock showed (1) higher percent change of Hct above the reference range, (2) lower platelet counts, (3) lower serum albumin level, and (4) elevated liver enzymes. Similarly, a number of previous studies showed that age >37 years, presence of bleeding, low total protein level, elevated liver enzyme ˃3-fold above reference range, and >2% of Hct above the reference range were independently associated with severe dengue [10, 35-38]. Regarding the outcomes of dengue patients in our study, patients with dengue shock were associated with (1) higher proportion with pleural effusion, (2) higher proportion with elevated troponin T level, (3) longer duration of hospitalization, and (4) higher in-hospital mortality which were similar to the previous studies [10, 12, 13].
Regarding primary hemodynamic assessment among patients with dengue, PP and HR except MAP significantly decreased from baseline during defervescence period. When compared to patients without dengue shock, the significant narrowing of the PP among patients with dengue shock was observed between day 4 and day 7 after fever onset, but the significantly decreased of MAP was observed only on day 6 after fever onset. Similarly, previous study from Vietnam
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