Prophylactic platelets in dengue: survey responses highlight lack of an evidence base

James Whitehorn; Rosmari Rodriguez Roche; Maria G Guzman; Eric Martinez; Wilmar Villamil Gomez; Leonard Nainggolan; Ida Safitri Laksono; Ajay Mishra; Lucy Lum; Abul Faiz; Amadou Sall; Joshua Dawurung; Alvaro Humberto Diniz Borges; Yee-Sin Leo; Lucille Blumberg; Daniel G Bausch; Axel Kroeger; Olaf Horstick; Guy Thwaites; Heiman Wertheim; Mattias Larsson; Tran Tinh Hien; Rosanna Peeling; Bridget Wills; Cameron Simmons; Jeremy Farrar

doi:10.1371/journal.pntd.0001716

Prophylactic platelets in dengue: survey responses highlight lack of an evidence base

James Whitehorn, Rosmari Rodriguez Roche, Maria G Guzman, Eric Martinez, Wilmar Villamil Gomez, Leonard Nainggolan, Ida Safitri Laksono, Ajay Mishra, Lucy Lum, Abul Faiz, Amadou Sall, Joshua Dawurung, Alvaro Humberto Diniz Borges, Yee-Sin Leo, Lucille Blumberg, Daniel G Bausch, Axel Kroeger, Olaf Horstick, Guy Thwaites, Heiman WertheimMattias Larsson, Tran Tinh Hien, Rosanna Peeling, Bridget Wills, Cameron Simmons, Jeremy Farrar

19 Citationer (Scopus)

Abstract

Dengue is the most important arboviral infection of humans. Thrombocytopenia is frequently observed in the course of infection and haemorrhage may occur in severe disease. The degree of thrombocytopenia correlates with the severity of infection, and may contribute to the risk of haemorrhage. As a result of this prophylactic platelet transfusions are sometimes advocated for the prevention of haemorrhage. There is currently no evidence to support this practice, and platelet transfusions are costly and sometimes harmful. We conducted a global survey to assess the different approaches to the use of platelets in dengue. Respondents were all physicians involved with the treatment of patients with dengue. Respondents were asked that their answers reflected what they would do if they were the treating physician. We received responses from 306 physicians from 20 different countries. The heterogeneity of the responses highlights the variation in clinical practice and lack of an evidence base in this area and underscores the importance of prospective clinical trials to address this key question in the clinical management of patients with dengue.

Originalsprog	Engelsk
Tidsskrift	P L o S Neglected Tropical Diseases (Online)
Vol/bind	6
Udgave nummer	6
Sider (fra-til)	e1716
ISSN	1935-2735
DOI	https://doi.org/10.1371/journal.pntd.0001716
Status	Udgivet - jun. 2012

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Whitehorn, J., Rodriguez Roche, R., Guzman, M. G., Martinez, E., Gomez, W. V., Nainggolan, L., Laksono, I. S., Mishra, A., Lum, L., Faiz, A., Sall, A., Dawurung, J., Borges, A. H. D., Leo, Y-S., Blumberg, L., Bausch, D. G., Kroeger, A., Horstick, O., Thwaites, G., ... Farrar, J. (2012). Prophylactic platelets in dengue: survey responses highlight lack of an evidence base. P L o S Neglected Tropical Diseases (Online), 6(6), e1716. https://doi.org/10.1371/journal.pntd.0001716

Whitehorn, J, Rodriguez Roche, R, Guzman, MG, Martinez, E, Gomez, WV, Nainggolan, L, Laksono, IS, Mishra, A, Lum, L, Faiz, A, Sall, A, Dawurung, J, Borges, AHD, Leo, Y-S, Blumberg, L, Bausch, DG, Kroeger, A, Horstick, O, Thwaites, G, Wertheim, H, Larsson, M, Hien, TT, Peeling, R, Wills, B, Simmons, C & Farrar, J 2012, 'Prophylactic platelets in dengue: survey responses highlight lack of an evidence base', P L o S Neglected Tropical Diseases (Online), bind 6, nr. 6, s. e1716. https://doi.org/10.1371/journal.pntd.0001716

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abstract = "Dengue is the most important arboviral infection of humans. Thrombocytopenia is frequently observed in the course of infection and haemorrhage may occur in severe disease. The degree of thrombocytopenia correlates with the severity of infection, and may contribute to the risk of haemorrhage. As a result of this prophylactic platelet transfusions are sometimes advocated for the prevention of haemorrhage. There is currently no evidence to support this practice, and platelet transfusions are costly and sometimes harmful. We conducted a global survey to assess the different approaches to the use of platelets in dengue. Respondents were all physicians involved with the treatment of patients with dengue. Respondents were asked that their answers reflected what they would do if they were the treating physician. We received responses from 306 physicians from 20 different countries. The heterogeneity of the responses highlights the variation in clinical practice and lack of an evidence base in this area and underscores the importance of prospective clinical trials to address this key question in the clinical management of patients with dengue.",

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author = "James Whitehorn and {Rodriguez Roche}, Rosmari and Guzman, {Maria G} and Eric Martinez and Gomez, {Wilmar Villamil} and Leonard Nainggolan and Laksono, {Ida Safitri} and Ajay Mishra and Lucy Lum and Abul Faiz and Amadou Sall and Joshua Dawurung and Borges, {Alvaro Humberto Diniz} and Yee-Sin Leo and Lucille Blumberg and Bausch, {Daniel G} and Axel Kroeger and Olaf Horstick and Guy Thwaites and Heiman Wertheim and Mattias Larsson and Hien, {Tran Tinh} and Rosanna Peeling and Bridget Wills and Cameron Simmons and Jeremy Farrar",

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AU - Gomez, Wilmar Villamil

AU - Nainggolan, Leonard

AU - Laksono, Ida Safitri

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AU - Faiz, Abul

AU - Sall, Amadou

AU - Dawurung, Joshua

AU - Borges, Alvaro Humberto Diniz

AU - Leo, Yee-Sin

AU - Blumberg, Lucille

AU - Bausch, Daniel G

AU - Kroeger, Axel

AU - Horstick, Olaf

AU - Thwaites, Guy

AU - Wertheim, Heiman

AU - Larsson, Mattias

AU - Hien, Tran Tinh

AU - Peeling, Rosanna

AU - Wills, Bridget

AU - Simmons, Cameron

AU - Farrar, Jeremy

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AB - Dengue is the most important arboviral infection of humans. Thrombocytopenia is frequently observed in the course of infection and haemorrhage may occur in severe disease. The degree of thrombocytopenia correlates with the severity of infection, and may contribute to the risk of haemorrhage. As a result of this prophylactic platelet transfusions are sometimes advocated for the prevention of haemorrhage. There is currently no evidence to support this practice, and platelet transfusions are costly and sometimes harmful. We conducted a global survey to assess the different approaches to the use of platelets in dengue. Respondents were all physicians involved with the treatment of patients with dengue. Respondents were asked that their answers reflected what they would do if they were the treating physician. We received responses from 306 physicians from 20 different countries. The heterogeneity of the responses highlights the variation in clinical practice and lack of an evidence base in this area and underscores the importance of prospective clinical trials to address this key question in the clinical management of patients with dengue.

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KW - Humans

KW - Male

KW - Platelet Transfusion

KW - Questionnaires

KW - Thrombocytopenia

KW - Treatment Outcome

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Prophylactic platelets in dengue: survey responses highlight lack of an evidence base

Abstract

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