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Critical care for dengue in adult patients

an overview of current knowledge and future challenges

Pang, Junxiong; Leo, Yee-Sin; Lye, David C.

Current Opinion in Critical Care: October 2016 - Volume 22 - Issue 5 - p 485–490
doi: 10.1097/MCC.0000000000000339
INFECTIOUS DISEASES: Edited by Tobias Welte
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Purpose of review This review aims to update and summarize the current knowledge about clinical features, management, and risk factors of adult dengue patients requiring intensive care with consequently higher risk of mortality.

Recent findings Increasingly, there are more adult dengue patients who require intensive care. This may be due to a shift in epidemiology of dengue infection from mainly a pediatric disease toward adult disease. In addition, multiorgan dysfunction was observed to be a key risk factor for ICU admission and mortality. This may be due to older adults having preexisting comorbidities that potentially predispose to have multiple severe organ impairment. Interventions remain largely supportive but also require more evidence-based trials and treatment protocols.

Summary These findings highlight the common clinical manifestations of adult dengue patients and the challenges of clinical management in ICU. Risk factors for prediction of adult dengue patients who require ICU are available, but they lack validation and consistent study design for meta-analysis in future. Early recognition of these risk factors, with close monitoring and prompt clinical management, remains critical to reduce mortality.

aInstitute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital

bSaw Swee Hock School of Public Health

cYong Loo Lin School of Medicine, National University of Singapore

dLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

Correspondence to David C. Lye, Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Moulmein Road, Singapore 308433, Singapore. E-mail: David_Lye@ttsh.com.sg

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