Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.

Dengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assesse...

Full description

Bibliographic Details
Main Authors: Bethell, D, Gamble, J, Pham, P, Nguyen, MD, Tran, T, Ha, T, Dong, T, Gartside, I, White, N, Day, N
Format: Journal article
Language:English
Published: 2001
_version_ 1797089211742945280
author Bethell, D
Gamble, J
Pham, P
Nguyen, MD
Tran, T
Ha, T
Tran, T
Dong, T
Gartside, I
White, N
Day, N
author_facet Bethell, D
Gamble, J
Pham, P
Nguyen, MD
Tran, T
Ha, T
Tran, T
Dong, T
Gartside, I
White, N
Day, N
author_sort Bethell, D
collection OXFORD
description Dengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assessed microvascular permeability, by use of strain gauge plethysmography, in Vietnamese children with DSS (n=19), or dengue hemorrhagic fever (DHF) without shock (n=16), and in healthy control children (n=15). At admission and after fluid resuscitation, the mean coefficient of microvascular permeability (K(f)) for the patients with dengue was approximately 50% higher than that for the control patients (P=.02). There was no significant difference in K(f) between the 2 groups of patients with dengue; this suggests the same underlying pathophysiology. We hypothesize that in patients with DSS, the fluctuations in K(f) are larger than those in patients with DHF, which leads to short-lived peaks of markedly increased microvascular permeability and consequent hemodynamic shock.
first_indexed 2024-03-07T03:01:09Z
format Journal article
id oxford-uuid:b1022739-e71b-484f-8665-bcedee51634b
institution University of Oxford
language English
last_indexed 2024-03-07T03:01:09Z
publishDate 2001
record_format dspace
spelling oxford-uuid:b1022739-e71b-484f-8665-bcedee51634b2022-03-27T04:00:39ZNoninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b1022739-e71b-484f-8665-bcedee51634bEnglishSymplectic Elements at Oxford2001Bethell, DGamble, JPham, PNguyen, MDTran, THa, TTran, TDong, TGartside, IWhite, NDay, NDengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assessed microvascular permeability, by use of strain gauge plethysmography, in Vietnamese children with DSS (n=19), or dengue hemorrhagic fever (DHF) without shock (n=16), and in healthy control children (n=15). At admission and after fluid resuscitation, the mean coefficient of microvascular permeability (K(f)) for the patients with dengue was approximately 50% higher than that for the control patients (P=.02). There was no significant difference in K(f) between the 2 groups of patients with dengue; this suggests the same underlying pathophysiology. We hypothesize that in patients with DSS, the fluctuations in K(f) are larger than those in patients with DHF, which leads to short-lived peaks of markedly increased microvascular permeability and consequent hemodynamic shock.
spellingShingle Bethell, D
Gamble, J
Pham, P
Nguyen, MD
Tran, T
Ha, T
Tran, T
Dong, T
Gartside, I
White, N
Day, N
Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.
title Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.
title_full Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.
title_fullStr Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.
title_full_unstemmed Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.
title_short Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.
title_sort noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever
work_keys_str_mv AT bethelld noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT gamblej noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT phamp noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT nguyenmd noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT trant noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT hat noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT trant noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT dongt noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT gartsidei noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT whiten noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever
AT dayn noninvasivemeasurementofmicrovascularleakageinpatientswithdenguehemorrhagicfever