1 in 4 dengue patients at aiims didn't need blood transfusion

1. 1 in 4 dengue patients at AIIMS
didn't need blood transfusion
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2. Contd…
A study has concluded that nearly one out of every four dengue patients
(23.2%) administered platelet transfusion during the 2013 outbreak at AIIMS
did not need it. The department of transfusion medicine at the hospital
conducted this study on 531 dengue patients, including 376 men and 155
women. It has been published in a recent issue of the Transfusion Medicine
and Hemotherapy , an international medical journal.
Researchers claim that many patients were given prophylactic transfusion to
allay anxiety , both among the patient and the treating physician regarding
worsening of condition. TOI spoke to Dr Bharat Singh, who heads Delhi State
Blood Transfusion Centre, on the issue. He said that inappropriate platelet
transfusion is common among all hospitals, both public and private.
“Many clinicians are uninformed about the condition where platelet
transfusion is necessary . Others succumb to pressure from patient's family
members,“ Dr Singh added.
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3. Contd…
Platelet is a blood component that helps in clotting.The normal platelet
count in human beings ranges between 1.5 to 4 lakh. In dengue fever, there
is increased destruction of platelets and reduction in the formation of new
ones which leads to low platelet count, say doctors.
While transfusion in patients with platelet count less than 20,000 units and
clinical parameters such as bleeding or rashes is important to check
hemorrhage, doctors say prophylactic transfusion can be counter-productive
as it triggers an immune response.
“Our analysis on need for platelet transfusion is from the perspective of a
pathologist. Physicians may have their own explanation for administering it,“
said Dr Kabita Chatterjee, faculty-incharge of the blood bank at AIIMS, who
was part of the study.
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4. Contd…
Experts said cancer patients are major consumers of platelet products.
“In developing countries like India, where the component separation
facilities are limited, optimal usage of platelet products is of paramount
importance, especially during periods of increased demands such as
dengue epidemics so that other needy patients are not deprived of it,“
said an expert.
He said educating clinicians about evidence-based transfusion practices
is needed to reduce inappropriate transfusions and decrease the strain
on facilities, especially at the time of epidemics. Experts also stress on
the need for constitution of hospital transfusion committee and close
coordination between facilities and physicians ordering blood
components to ensure optimal utilisation of scarce resources.
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5. Contd…
This year, Delhi saw one of the worst outbreaks in decades with over
15,000 confirmed cases and 38 deaths. “Many needy patients struggled
to get beds in hospitals. Due to panic, even those with high platelet
count insisted on transfusion,“ said a doctor.
Termed by many experts as the world's most rapidly spreading viral
disease, dengue is caused by four serotypes. While type I and III are
mild causing classic dengue fever and fever without shock, respectively
, dengue type II and IV are considered deadly . These cause fever,
bleeding and a drop in platelet count. This year, studies have shown,
type II and type IV were dominant strains.
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