Immediate treatment of choice for severe hypotension in Dengue shock syndrome?
**Core Concept**
Severe hypotension in Dengue shock syndrome is a life-threatening condition requiring immediate treatment to restore blood pressure and maintain perfusion of vital organs. The underlying pathophysiology involves plasma leakage, thrombocytopenia, and coagulopathy, leading to hypovolemic shock.
**Why the Correct Answer is Right**
The immediate treatment of choice for severe hypotension in Dengue shock syndrome involves fluid replacement therapy to restore circulating volume and blood pressure. Crystalloids such as Ringer's lactate or normal saline are administered intravenously to expand intravascular volume and improve cardiac output. This approach helps to maintain perfusion of vital organs and prevent further complications. The goal is to achieve a systolic blood pressure of at least 90 mmHg.
**Why Each Wrong Option is Incorrect**
**Option A:** Blood transfusion in Dengue shock syndrome is not recommended as it may exacerbate the coagulopathy and increase the risk of bleeding.
**Option B:** Vasopressors such as dopamine or norepinephrine may be used in refractory shock, but they are not the first-line treatment for severe hypotension in Dengue shock syndrome.
**Option D:** Corticosteroids are not recommended in the treatment of Dengue shock syndrome as they may worsen the outcome.
**Clinical Pearl / High-Yield Fact**
In Dengue shock syndrome, early recognition and aggressive fluid replacement therapy are critical to prevent complications and improve outcomes. A systolic blood pressure of at least 90 mmHg should be maintained to ensure adequate perfusion of vital organs.
**Correct Answer: C. Crystalloids such as Ringer's lactate or normal saline.**