Role of platelet transfusion in the management of dengue patients in a tertiary care hospital

Abstract

Background and Objective:While medical fraternity globally recognizes the role of platelet transfusion in the management of hospitalized dengue patients the exact indications and situations in which these are to be transfused may vary. Since there is inherent risk associated with the transfusion of blood/blood-component, it is imperative for each institution (or country) to lay their own criteria for transfusion of these blood components. The present study was conducted to lay precise criteria and transfusion trigger for platelet transfusion in our set-up.Materials and Methods:The present study was conducted on 225 serologically confirmed dengue patients admitted at Indraprastha Apollo Hospitals between 1st of August to 30th of November 2005. Clinical data, reports of hematological investigation, platelets requirements and data obtained from daily follow-up were analyzed. The clinicians followed the guidelines issued by the Directorate of Health services, NCT of Delhi.Results:In the serologically confirmed cases, the prevalence of thrombocytopenia (count less than 100,000/cumm) was 84.88% on admission and bleeding was recorded in 22 (9.7%) patients. About 96 (42.6%) patients of dengue cases received platelet transfusion. Among them 47 (20.88%) patients had a platelet count < 20,000/cumm, 43 (19.11%) had a platelet count in the range of 21-40,000/cumm while 6 (2.66%) patients had the platelet count in between 41 and 50,000/cumm. Out of 49 patients with a platelet count >20,000/cumm, 18 patients had haemorrhagic manifestations such as petechiae, gum-bleeding, epistaxis, etc., which necessitates the use of platelet transfusion. However, 31 patients received inappropriate platelet transfusion.Conclusion:This study suggests that bleeding occurs more often in patients with severe thrombocytopenia. High-risk patients having platelet count < 20,000/cumm and risk of bleeding require urgent platelet transfusion. Patients with platelet count 21-40,000/cumm are in moderate risk and require platelet transfusion only if they have any haemorrhagic manifestations and other superadded conditions.

Spectrum of Liver Dysfunction in Patients with Dengue Infection and the Markers of Severe Disease: Study from a Tertiary Care Centre in Punjab

“…In this study most of the patients (88.3%) had classical Dengue fever while DHF and DSS were present in 7.5% and 4.3% patients respectively. The results are similar to a study from Delhi where in Dengue fever was seen in majority while DHF and DSS were seen in 9.3% and 2.2% of the total cases respectively [12]. Liver dysfunction in the form of Transaminasemia (SGOT/SGPT>ULN) was found ubiquitously (98.9%) in our study.…”

Clinical and laboratory profile of different dengue sub types in dengue virus infection

“…This is as with the results of a recent study from Punjab done by Chhinaet al (DHF and DSS in 13.6% and 5.1% respectively) and from Delhi done by Makroo et al (DHF and DSS in 9.3% and 2.2% respectively). 7,8 However a few other studies had reported a higher percentage of DHF. 9,10 The mean age of patients in our study was 34.63± 13.28 years, with male to female ratio being near equal.…”

Usage of blood products in emergency department at tertiary care centre

“…10 Viral fevers especially from dengue have become a quite common indication for platelet transfusion in India. 11 In all the transfusion there will be chances of transfusion transmitted diseases, allergic reaction and other forms of transfusion reactions leading to increased mortality and morbidity in the patients.…”