A 26-year-old man with dengue develops cold clammy extremities, pulse pressure of 18 mmHg, and tachycardia on day 5 of illness. He is conscious and passes urine. Intravenous access is secured. Which fluid should be given first?

• A Five percent dextrose in water
• B Hydroxyethyl starch solution
• C Fresh frozen plasma
• D Isotonic crystalloid such as Ringer lactate ✓

Explanation

WHO guidance for compensated dengue shock recommends immediate isotonic crystalloid resuscitation, typically Ringer lactate or normal saline, beginning around 5 to 10 mL/kg per hour in adults with reassessment after each bolus. Colloids are reserved for patients who fail to improve after adequate crystalloid boluses. Fresh frozen plasma does not address the capillary plasma leak driving shock, and dextrose solutions distribute freely into all compartments and provide no intravascular volume expansion.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.