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

TY - JOUR

T1 - Prophylactic platelets in dengue

T2 - survey responses highlight lack of an evidence base

AU - Whitehorn, James

AU - Rodriguez Roche, Rosmari

AU - Guzman, Maria G

AU - Martinez, Eric

AU - Gomez, Wilmar Villamil

AU - Nainggolan, Leonard

AU - Laksono, Ida Safitri

AU - Mishra, Ajay

AU - Lum, Lucy

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

PY - 2012/6

Y1 - 2012/6

N2 - 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.

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.

KW - Adolescent

KW - Adult

KW - Blood Platelets

KW - Dengue

KW - Female

KW - Humans

KW - Male

KW - Platelet Transfusion

KW - Questionnaires

KW - Thrombocytopenia

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1371/journal.pntd.0001716

DO - 10.1371/journal.pntd.0001716

M3 - Journal article

C2 - 22745847

SN - 1935-2735

VL - 6

SP - e1716

JO - P L o S Neglected Tropical Diseases (Online)

JF - P L o S Neglected Tropical Diseases (Online)

IS - 6

ER -