Abstract
ABSTRACT Shock is life threatening feature of DHF it must be manage properly through close clinical and laboratory observations. This was a pre-eliminary study to evaluate hematocrit (Hct) increased where shock occurs on dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). The WHO criteria was used to diagnose DHF, with two or more clinical criteria with trombocytopenia (≤ 100.000) and Hct increase ≥ 20 %. Examination of hemoglobin (Hb), Hct, thrombocytes and leucocytes were done in RSU Dr. Saiful Anwar Central Laboratory everyday during hospitalized. The increase of Hct percentage and Hct/Hb ratio calculation were based on the result of lowest dan highest Hct and Hb examination. The data obtains was analysed with t-test using SPSS version 10.0 programme. From 30 DHF cases, 23 (76.66%) non DSS and 7 (23.77%) DSS. The average Hct increase in all patients from serial examinations was 21.09% (SD= 2.32%). However, in 7 DSS patients the average Hct increase was 23.79% (SD= 3.84%) higher than the 23 non DSS patients (20.28%; SD= 0.25%). It was observed that the Hct increase in DSS patients was higher than that for non DSS patients. This high Hct level of 23.79% increases the likelihood of shock by 2.5 times compare with an Hct rise of 20.28%. There was a significant difference in the highest and lowest Hct/Hb ratio between DSS and non DSS cases (p= 0.000). Keywords : dengue hemorrhagic fever, dengue shock syndrome, hematocrit increase, Hct/Hb ratio
Highlights
Shock is life threatening feature of dengue hemorrhagic fever (DHF) it must be manage properly through close clinical and laboratory observations
In 7 dengue shock syndrome (DSS) patients the average Hct increase was 23.79% (SD= 3.84%) higher than the 23 non DSS patients (20.28%; SD= 0.25%)
It was observed that the Hct increase in DSS patients was higher than that for non DSS patients. This high Hct level of 23.79% increases the likelihood of shock by 2.5 times compare with an Hct rise of 20.28%
Summary
Kasus DBD diambil dari penderita anak yang dirawat di Bagian Ilmu Kesehatan Anak RSU Dr Saiful Anwar Malang. Diagnosis DBD ditegakkan berdasarkan kriteria WHO (1999) yaitu ditemukannya dua atau lebih kriteria klinis disertai trombositopenia dan hemokonsentrasi (peningkatan Ht). Penderita didiagnosis sindrom syok dengue (SSD) apabila ditemukan tanda-tanda kegagalan sirkulasi atau renjatan, antara lain takikardi, nadi cepat dan lemah, tekanan nadi menyempit (20 mmHg atau kurang), akral dingin, oliguria, dan hipotensi. Pemeriksaan darah rutin, meliputi Hb, Ht, trombosit dan leukosit dilakukan setiap hari selama penderita dirawat. Pemeriksaan laboratorium dilakukan di laboratorium sentral RSU Dr Saiful Anwar Malang. Persentase kenaikan Ht dan rasio Ht/Hb dihitung berdasarkan hasil pencatatan serial nilai Ht dan Hb yang tertinggi dan terendah selama perawatan. Dari data yang terkumpul dilakukan tabulasi dan analisis dengan t-test menggunakan program SPSS versi 10.0
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