Study on the effectiveness of transfusion program in dengue patients receiving platelet transfusion

Abstract

Aims: Dengue infection is a global health problem affecting an estimated population of 50–100 millions every year. Thrombocytopenia is an essential diagnostic criteria. Platelet transfusion is given in those patients who have haemorrhagic manifestations along with thrombocytopenia. The aim of the study was to know the effectiveness of platelet transfusion in dengue patients. Methods: The study was conducted during the epidemic of dengue fever from July 2011 to October 2011. Serologically confirmed dengue cases were included in the study. Results: Two hundred thirty two patients were positive for dengue serological tests of which 195 (84.2%), 35 (15%), 2 (0.8%) were DF, DHF DSS respectively. One hundred eighty two (78.4%) patients received platelet transfusion. One hundred eighteen (51%) cases received single unit of platelet transfusion though platelet count was between 0.2–1.0x10x105/mm3. Sixty four (27.5%) patients who had platelet count <0.2x105/mm3 received multiple platelet transfusions. The patient who received multiple platelet transfusion of 10–12 units showed post transfusion increment of >0.5x105/mm3 and they were discharged after 5–6 days of hospitalization. Conclusions: This study suggests that 51% platelet transfusions are inappropriate and it is more effective when it is given to patients with platelet count <0.2x105/mm3. Platelet transfusion practice should be based upon platelet count and haemorrhagic manifestations as this decreases hospitalization of the patients and complications of dengue.

Maternal and fetal outcome of dengue fever during pregnancy

“…All these patients had platelet counts less than 50,000 cells/mm 3 . This finding is in conjunction with another study by Kulkarni et al 5 They also noticed that sixty nine percentage of the haemorrhagic manifestations occurred in patients with severe thrombocytopenia.…”

Acute undifferentiated febrile illness in patients presenting to a Tertiary Care Hospital in South India: clinical spectrum and outcome

“…[8] Reported rates of hemorrhagic manifestations in Indian studies vary between 6 and 37%. [9101112] Our study had a higher prevalence of severe dengue cases (11%) compared to that reported by Souza et al . (7.6%).…”

“…[9] However, the rate of platelet transfusion in our study (7.2%) was much lesser than the rate of 20–51% reported in other studies. [101112] In our hospital, platelet transfusion was given only with significant bleeding or for therapeutic interventions such as obtaining a central venous access or performing a gastroscopy. However, in many places, platelets are transfused not based on medical rationale, but as a response to an intense social pressure on the treating physicians by the patients or their relatives.…”

Transfusion support in patients with dengue fever

“…[ 37 ] Inappropriate platelet transfusions in absence of bleeding have been reported from 13% to as high as 56.2% by various authors. [ 38 39 40 ] A study conducted in four tertiary level hospitals of Delhi observed that 73.5% of patients with dengue hemorrhagic fever and 48.7% of dengue fever classified as per WHO guidelines were given platelet transfusions. [ 41 ] Sugianto et al .…”