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

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 re...

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Bibliographic Details
Main Authors: Whitehorn, James (Author) , Horstick, Olaf (Author)
Format: Article (Journal)
Language:English
Published: June 26, 2012
In: PLoS neglected tropical diseases
Year: 2012, Volume: 6, Issue: 6
ISSN:1935-2735
DOI:10.1371/journal.pntd.0001716
Online Access:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1371/journal.pntd.0001716
Verlag, kostenfrei, Volltext: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0001716
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Author Notes: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 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

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520 |a 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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