Correlation between hematocrit and inferior vena cava collapsibility in adult patients with dengue fever: A prospective, observational study at a tertiary care setup in Eastern India

Abstract

Background: Dengue fever (DF) is a vector-borne arboviral infection prevalent in tropical and sub-tropical countries. Early recognition of severity of the disease with appropriate fluid management is a challenge to the clinicians. Increase in capillary permeability is the pathophysiological hallmark of the disease which parallels with increase in hematocrit. This study aimed to evaluate the inferior vena cava (IVC) collapsibility and its relation to hematocrit. Methods: A prospective, observational study was conducted in the inpatient department of tropical medicine over a period of 1 year in a tertiary care set up in Eastern India. Clinical data and hematocrit of adult dengue cases were documented and their IVC collapsibility determined by bedside ultrasonography (USG) was recorded. Association was assessed between IVC collapsibility and hematocrit. Results were statistically analyzed. Results: Seventy dengue cases were included - 59 cases of DF with warning signs and 11 cases of dengue hemorrhagic fever (DHF). 85.7% of study population presented at febrile phase of their illness. Bedside USG was correlated with hematocrit on day 2 of admission. IVC was collapsible in 79.7% cases of DF and 90.9% cases of DHF. Of the 47 DF cases with collapsible IVC, 95.7% had high hematocrit, while all DHF cases with collapsible IVC had high hematocrit. A significant association between IVC collapsibility and hematocrit was noted (P = 0.000). Conclusion: The assessment of intravascular volume status by bedside USG-IVC collapsibility is a helpful noninvasive and better tool than hematocrit for determining fluid resuscitation in DF.