dengue shock syndrome with diagrams
Transcript of dengue shock syndrome with diagrams
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Shock Hipovolemik
pada DSS
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Mekanisme
Kompleks virus-antibodi non-netralisasi
Aktivasi sistem koagulasiAgregasi trombosit
Gangguan fingsitrombosit
PengeluaranPF 3
Aktivasi sistem komplemen
Destruksi trombositoleh RES
trombositopenia
AktivasiFaktor Hageman
Aktivasi kinin
Secondary heterologous infection
Anafilatoksin
Peningkatan permeabilitasPembuluh darah
RenjatanPerdarahan massif
Penurunan faktorPembekuan darah
Koagulopatikonsumtif
FDP meningkat
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STAGE OF SHOCKInitial stage :
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Compensatory Stage :
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Progressive Stage :
If could give the cells more O2 become futile bcoz couldn’t process & use it affect every organ & body processes
Refractory Stage : point of no return
DEATH!!
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Dengue Shock Syndrom (DSS)
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DEFINISI
Demam dengue dan demam berdarah dengue adalah penyakit infeksi yang disebabkan oleh virus dengue dengan manifestasi klinis demam, nyerri otot atau nyeri sendi yang disertai leukopenia, ruam, limfadenopati, trombositopenia. Pada DBD terjadi perembesan plasma yang ditandai oleh hemokonsentrasi atau penumpukan cairan di rongga tubuh. Sindrom renjatan dengue adalah demam berdarah yang ditandai oleh renjatan atau syok.
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DIAGNOSIS
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DEMAM DENGUE
Penyakit demam akut selama 2-7 hari ditandai dengan dua atau lebih manifestasi klinis sbg berikut:
Nyeri kepala Nyeri retro orbital Mialgia/artralgia Ruam kulit Manifestasi perdarahan (petekie atau uji bendung positif) Leukopenia dan pemeriksaan serologi positif
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DEMAM BERDARAH DENGUE
Berdasarkan kriteria WHO 1997 diagnosis DBD ditegakkan bila semua hal bawah dipenuhi
1. Demam atau riwayat demam akut, antara 2-7 hari biasanya bifasik
2. Terdapat minimal satu dari manifestasi perdarahan
- uji bendung positif
- petekie ekimosis atau purpura
- perdarahan mukosa
- hematemesis atau melena
3. Trombositopenia
4. Terdapat minimal satu tanda-tanda plasma leakage
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- peningkatan hematokrit >20% dibandingkan standart sesuai umur dan jenis kelamin
- penurunan hematokrit >20 % setelah mendapat terapi cairan, dibandingkan dengan nilai hematokrit sebelumnya
- tanda kebocoran plasma seperti efusi pleura, ascites atau hipoproteinemia
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SINDROMA SYOK DENGUE
Seluruh kriteria untuk DBD disertai kegagalan sirkulasi dengan manifestasi nadi yang cepat dan lemah, tekanan darah tururn, hipotensi dibandingkan standar sesuai umur, kulit dingin dan lembap serta gelisah
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Pathogenesis
2 main pathophysiological changes occur in DHF/DSS↑ vascular permeabilityDisorder in hemostasis
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Pathogenesis
↑ vascular permeability
Loss of plasma from the vascular compartment
Hemoconcentration, low pulse pressure, and other signs of shock
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Pathogenesis
Activation of complement system, with profound depression of C3 and C5 levels, is a constant.
Platelet defects may be both qualitative and quantitative.
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Mekanisme Tubuh atasi Perdarahan
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1. Peningkatan pemakaian2. Destruksi trombosit perifer
TROMBOSITOPENIA
PeningkatanDestruksiTrombositOleh RES
Agregasi trombosit akibatEndotel vaskular yg rusak
PenurunanProduksi
Trombosit Oleh
Sumsum tulang
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HEMOSTASIS
1. Spasme pembuluh darah yang terluka
2. Pembentukan sumbat platelet
3. Kaskade koagulasi Jalur intrinsik (XII, XI, IX, X, V) Jalur ekstrinsik (III, VII) Jalur bersama (XIII, I, II )
4. Fibrinolisis
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Sifat Virus
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Mekanisme Gejala Klinis
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Patogenesis Syok dan efusi pleura pada DHF
Secondary heterologous infection
Replikasi virus respon antibodi anamnestik
Kompleks virus-antibodi
Aktivasi komplemen
Anafilatoksin
Permeabilitas kapiler meningkat Syok
hipovolemiaPerembesan plasma efusi
pleura
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PENATALAKSANAAN &
PROGNOSIS
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Prognosis Survival is related directly to early
hospitalizationand aggressive supportive care Treated promptly children in shock and coma
can wake up and return to near normalicy within hours
Convalescence may be prolonged with weakness and mental depression
Continued back pain, bradycardia, and premature ventricular contraction (PVCs) are common
Dengue fever is not contagious through person to person contact
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Pencegahan
Pengendalian vektor (Aedes aegypty)Kimiawi larvasida (abate), foggingBiologi tanaman Geranium (blm ada
penelitian), pengendalian perkembangbiakan nyamuk (memandulkan nyamuk jantan)
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KESIMPULAN
Susi mengalami Dengue Shock Syndrom dan memerlukan penanganan segera.