To transfuse or not to: The dengue dilemma continues - A study of transfusion patterns at hospital based blood bank

Introduction: Dengue is an arboviral infection which is endemic in several nations and is soon becoming an epidemic in India. It manifests as asymptomatic, mild to severe forms, the latter complicated by bleeding and shock. Thrombocytopenia is usually associated with bleeding, the degree of thrombocytopenia may or may not be related to the severity of bleeding. Thrombocytopenia is generally transient with spontaneous recovery of platelet counts. Coagulopathy, vasculopathy, platelet dysfunction contribute to bleeding in Dengue cases. Low platelet count being one of the criteria for severe dengue, evokes ‘Dengue Panic Syndrome’. Clinicians transfuse liberally overlooking its hazards thereby questioning the utility in cases with increasing counts thereby reducing the bleeding and causing financial burden to the patients and repercussions on transfusion services facing challenges of meeting the demand for this scarce resource.Aims & Objectives: The aim of this study is to analyse transfusion patterns in dengue, its association with haematology prognostication and extrapolate to appropriateness of transfusions.Materials and Methods: The study was conducted on 130 serologically positive Dengue cases in the Department of Haematology, Kempegowda Institute of Medical Sciences, Bangalore. All dengue cases with thrombocytopenia, transfused with blood components were included. Those with normal or increased platelet counts were excluded from the study. The data was reviewed from haematology, transfusion and serology records, tabulated and analysed.Results: Among the 130 cases studied, Dengue was found it be more common in adult males, Most of the dengue patients received multiple transfusions. Bleeding was noted in 17% of cases, in patients in whom the platelet counts was less than 20000 cells/cumm.Conclusion: Uniform blood transfusion guidelines is required to help in augmenting the use of apheresis of blood group type specific platelet units. Frequent post transfusion monitoring of transfusions are required to maximise efficacy and minimise inappropriate transfusions and wastage of blood.