Sanish Babu/LinkedIn
Sep 8, 2026, 15:18
Sanish Babu: Dengue Management – Watch the Hematocrit, Not Just the Platelets
Sanish Babu, Laboratory Medicine Consultant, MD Pathology, shared a post on X:
“Dengue Management: Watch the Hematocrit (Hct), Not Just the Platelets!
Thrombocytopenia is common, but plasma leakage is what turns dengue life-threatening.
Why serial Hematocrit is your most critical bedside marker:
The Capillary Leak Window:
Rising Hct indicates hemoconcentration due to active plasma leakage. A higher than 20% jump defines severe leakage.
The Red Flag Divergence:
Rapidly falling platelets with rising Hct indicates active capillary leak: hospitalize and start IV crystalloids immediately.
Fluid Titration Guide:
- Rising Hct with unstable vitals: Step up IV fluids.
- Falling Hct with stable vitals: Wean fluids to prevent iatrogenic pulmonary edema.
- Falling Hct with worsening shock: Look for occult hemorrhage, then transfuse blood, not more crystalloids.
Platelets show the diagnosis; Hematocrit guides the fluid resuscitation.”
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