Sandhya Raghavan
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Written By: Sandhya Raghavan | Updated : November 22, 2017 7:02 PM IST
One of the commonest complications of dengue is platelet loss. It's usually a cause for great concern since platelets or thrombocytes are life-saving blood cells whose primary function is to stop excessive bleeding caused by trauma. Whenever the body senses an injury or a broken blood vessel, platelets clump together and form a blood clot to stop the bleeding. In a healthy individual, the normal platelet count is anywhere between 1.5 to 4.5 lakhs. But in cases like dengue, ITP or leukaemia, the patient experiences a steep drop in the platelet count, which can increase their chances of spontaneous bleeding. Doctors generally recommend platelet transfusion for dengue patients whose counts are below 10k. But is a platelet transfusion necessary for every case of dengue? Not quite.
Dr Pradip Shah, Consultant Physician at Fortis Hospital says that panicky relatives often pressurise doctors performing platelet transfusions when the patient's platelet count starts dropping. "Transfusions are not always necessary in every dengue case and should be a last resort. A patient can manage even with a 15k count. There are cases where patients with even 10k count weren't given any transfusions and they managed well on their own," says Dr Shah. Although it is a life-saving procedure, patients and caregivers should note that it is not without its risks.
1 Hemolytic reactions
A hemolytic reaction can happen if the patients receive pheresis platelets and there is a blood group incompatibility (ABO-incompatibility). It's a potentially fatal reaction that can cost you your life. It can begin within minutes of the transfusion and the patient can experience fever, chills, lower back pain and a dread of impending death.
2 Transfusion-related injuries
Receiving large amount of plasma from a single donor can increase the chance of TRALI or transfusion-related lung injury. The problem causes accumulation of fluid in the tissues and air spaces of the lungs. The complication can then lead to respiratory failure in patients.
3 Infections
Although such instances are rare, platelet transfusions also increase the chances of hospital-acquired infections in the receiver.
4 Circulatory overload
Transfusion-associated circulatory overload or TACO is an underdiagnosed, underreported complication of blood transfusion which happens when there is a rapid transfusion of a large amount of blood. It is a possibly fatal complication that can cause breathlessness and increase in blood pressure. Elderly patients, infants and those with renal failure, anaemia, congestive heart failure and hypoalbuminemia are at greater risk.
5 Allergic attacks
Post-transfusion allergic reactions are always possible. The reaction is related plasma proteins and the symptoms can range from itching, hives and flushing to more severe ones like hypotension, bronchospasm and breathlessness. Symptom can start within minutes of the transfusion or could take several hours to develop.
Here are some household remedies for platelet loss.
References:
Sahu, S., Hemlata, & Verma, A. (2014). Adverse events related to blood transfusion. Indian Journal of Anaesthesia, 58(5), 543 551. http://doi.org/10.4103/0019-5049.144650
Cappellini, M. D., Cohen, A., Porter, J., Taher, A., & Viprakasit, V. (Eds.). (2014). Guidelines for the management of transfusion dependent thalassaemia (TDT) (pp. 148-9). Nicosia (CY): Thalassaemia International Federation.
Aubron, C., Flint, A. W., Bailey, M., Pilcher, D., Cheng, A. C., Hegarty, C., McQuilten, Z. (2017). Is platelet transfusion associated with hospital-acquired infections in critically ill patients? Critical Care, 21, 2. http://doi.org/10.1186/s13054-016-1593-x
Agnihotri, N., & Agnihotri, A. (2014). Transfusion associated circulatory overload. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 18(6), 396 398. http://doi.org/10.4103/0972-5229.133938
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