Unfurling the Rationale Use of Platelet Transfusion in Dengue Fever |
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Authors: | P Pallavi C K Ganesh K Jayashree G V Manjunath |
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Institution: | (1) Department of Pathology, JSS Medical College and Hospital, JSS University, Mysore, India;(2) JSS Medical College and Hospital, JSS University, Mysore, India |
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Abstract: | Dengue fever and dengue haemorrhagic fever have emerged as a global public health problem in recent decades. The practice
of platelet transfusion has been adapted into the standard clinical practice in management of hospitalized dengue patients.
The exact indications and situations in which platelet have to be transfused may vary greatly. Blood components especially
platelet concentrates due to their short shelf life are frequently in limited supply. Hence, appropriate use of blood is required
to ensure the availability of blood for patients in whom it is really indicated, as well as to avoid unnecessary exposure
of the patients to the risk of transfusion reactions and transmission of blood borne infection. The present study was conducted
to evaluate the appropriateness of platelet transfusion done in dengue patients with thrombocytopenia. The present study was
conducted on 343 serologically confirmed dengue patients admitted at JSS University Hospital between 1st January and 30th
August 2009. Clinical data, platelet count and platelet requirements were analyzed. Among the 343 serologically confirmed
cases, the prevalence of thrombocytopenia (platelet count < 100,000/cumm) was 64.72% (222 patients) and bleeding manifestations
were recorded in 6.12% (21 patients). 71 (20.7%) patients of dengue cases received platelet transfusion. Among them 34 (47.89%)
patients had a platelet count <20,000/cumm, 28 patients (39.44%) had platelet counts in the range of 21–40,000/cumm while
the remaining 9 (12.67%) patients had platelet count between 41–100,000/cumm. Out of 37 patients with a platelet count >20,000/cumm
11 patients had haemorrhagic manifestations such as petechiae, gum bleeding, epistaxis etc., which necessitates the use of
platelet transfusion. However, the remaining 26 patients with platelet count >20,000/cumm and with no haemorrhagic manifestations
received inappropriate platelet transfusion. Transfusion of 36.62% of platelet concentrate was inappropriate. The study emphasizes
the need for development of specific guidelines for transfusion of blood components, constant interaction and co-ordination
amongst clinicians and transfusion centre for implementation of these guidelines and a regular medical audit to review the
optimal utilization of blood components. |
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Keywords: | Dengue Haemorrhagic fever Platelet count Platelet transfusion Rationale use |
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