Published December 30, 2022 | Version v1
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Role of Blood Component Therapy in the Management of Dengue Hemorrhagic Fever Patients

  • 1. Medical Officer, Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

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Abstract: Background: Dengue Hemorrhagic Fever (DHF) is a severe, life- threatening complication of dengue virus infection, characterized by plasma leakage, thrombocytopenia, and potential hemorrhage. As there is no specific antiviral treatment, supportive management is paramount. Blood component therapy, including platelets and plasma, is a critical intervention to correct coagulopathy and stabilize patients. Objective: To analyze the utilization patterns, determinants, and clinical outcomes of blood component therapy in patients with DHF. Methods: A prospective observational study was conducted at Bangabandhu Sheikh Mujib Medical University from July 2021 to August 2022. Data from 290 laboratory- confirmed dengue patients, including 73 with DHF, were analyzed. Parameters included demographics, DHF grade, transfusion details, laboratory trends, and clinical outcomes. Statistical analysis used SPSS 23.0, with Chi-square and ANOVA tests for comparisons; a p-value <0.05 was considered significant. Results: Transfusion was administered to 71.3% of DHF patients, predominantly platelets alone. Requirement was strongly linked to severity, with 84.0% of severe cases receiving therapy. Key risk factors included warning signs and high hematocrit. Post-therapy platelet counts and hematocrit levels normalized significantly. Combination therapy was associated with longer hospital stays (7.4 days) and higher complication rates (e.g., 30% fluid overload), yet discharge rates remained high across all groups. Conclusion: Blood component therapy is crucial for severe DHF, effectively stabilizing hematological parameters. A targeted, severity-based approach is recommended to optimize outcomes and minimize complications associated with combination transfusions.

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References

  • Bhatt, S., Gething, P. W., Brady, O. J., Messina, J. P., Farlow, A. W., Moyes, C. L., ... & Hay, S. I. (2013). The global distribution and burden of dengue. Nature, 496(7446), 504-507.
  • Brady, O. J., Gething, P. W., Bhatt, S., Messina, J. P., Brownstein, J. S., Hoen, A. G., ... & Hay, S. I. (2012). Refining the global spatial limits of dengue virus transmission by evidence-based consensus.
  • World Health Organization, Special Programme for Research, Training in Tropical Diseases, World Health Organization. Department of Control of Neglected Tropical Diseases, World Health Organization. Epidemic & Pandemic Alert. (2009). Dengue: guidelines for diagnosis,treatment, prevention and control. World Health Organization.
  • Halstead, S. B. (2007). Dengue. The Lancet, 370(9599), 1644-1652.
  • Malavige, G. N., Fernando, S., Fernando, D. J., & Seneviratne, S. L. (2004). Dengue viral infections. Postgraduate medical journal, 80(948), 588-601.
  • Lye, D. C., Lee, V. J., Sun, Y., & Leo, Y. S. (2009). Lack of efficacy of prophylactic platelet transfusion for severe thrombocytopenia in adults with acute uncomplicated dengue infection. Clinical infectious diseases, 48(9), 1262-1265.
  • Rajapakse, S., Rodrigo, C., Maduranga, S., & Rajapakse, A. C. (2014). Corticosteroids in the treatment of dengue shock syndrome. Infection and drug resistance, 137-143.
  • Bodinayake, C. K., Tillekeratne, L. G., Nagahawatte, A., Devasiri, V., Kodikara Arachchi, W., Strouse, J. J., ... & Reller, M. E. (2018). Evaluation of the WHO 2009 classification for diagnosis of acute dengue in a large cohort of adults and children in Sri Lanka during a dengue-1 epidemic. PLoS neglected tropical diseases, 12(2), e0006258.
  • Trung Dinh The, T. D. T., Thao Le Thi Thu, T. L. T. T., Dung Nguyen Minh, D. N. M., Ngoc Tran Van, N. T. V., Hien Tran Tinh, H. T. T., Chau Nguyen Van Vinh, C. N. V. V., ... & Wills, B. (2012). Clinical features of dengue in a large Vietnamese cohort: intrinsically lower platelet counts an
  • Djamiatun, K., Van der Ven, A. J., de Groot, P. G., Faradz, S. M., Hapsari, D. E. A. H., Dolmans, W. M., ... & de Mast, Q. (2012). Severe dengue is associated with consumption of von Willebrand factor and its cleaving enzyme, ADAMTS- 13. PLoS neglected tropical diseases, 6(5), e1628.
  • Chaudhary, R., Khetan, D., Sinha, S., Sinha, P., Sonker, A., Pandey, P., ... & Ray, V. (2006). Transfusion support to dengue patients in ahospital-based blood transfusion service in north India. Transfusion and apheresis science, 35(3), 239-244.
  • Islam, M. T., Quispe, C., Herrera-Bravo, J., Sarkar, C., Sharma, R., Garg, N., ... & Cruz-Martins, N. (2021). Production, transmission, pathogenesis, and control of dengue virus: a literature‐based undivided perspective. BioMed Research International, 2021(1), 4224816.
  • Rajapakse, Senaka, Chaturaka Rodrigo, and Anoja Rajapakse. "Treatment of dengue fever." Infection and drug resistance (2012): 103-112.
  • World Health Organization and UNICEF. "Handbook for clinical management of dengue." (2012).
  • Malavige GN, Ogg GS. Pathogenesis of severe dengue infection. Cytokine. 2019; 123:154777
  • Lee, Tau Hong, et al. "Current management of severe dengue infection." Expert review of anti- infective therapy 15.1 (2017): 67-78.
  • Choudhury, Gargi Roy. "TRANSMEDCON 2021 Posters." Asian Journal of Transfusion Science 16. Suppl 1 (2022): S12-S45.
  • Tanner, Lukas, et al. "Decision tree algorithms predict the diagnosis and outcome of dengue fever in the early phase of illness." PLoS neglected tropical diseases 2.3 (2008): e196.
  • Dinh The Trung, Dinh the Trung, et al. "Liver involvement associated with dengue infection in adults in Vietnam." (2010): 774-780.
  • Wills, Bridget A., et al. "Comparison of three fluid solutions for resuscitation in dengue shock syndrome." New England Journal of Medicine 353.9 (2005): 877-889.
  • Assir, Muhammad Zaman Khan, et al. "Effectiveness of platelet transfusion in dengue fever: a randomized controlled trial." Transfusion Medicine and Hemotherapy 40.5 (2013): 362-368.
  • Lum ChaiSee [Lum, CSL, et al. "Preventive transfusion in dengue shock syndrome-is it necessary?" (2003): 682-684.