The behavior of transfused platelets in dengue hemorrhagic fever

The transfusion of platelet concentrate has been proved as a valuable clinical procedure in the management of bleeding in dengue hemorrhagic fever (DHF). This paper described the behavior of transfused platelets as platelet response and platelet increment in DHF patients with and without shock. Fifteen patients with DHF were studied, aged 2 to 12 years old. All had bleeding manifestation, ie GI, skin, nose or gum. Fresh human platelet concentrate was transfused to 5 non-shock cases and 10 shock cases with different dosages as the low dose (0.15-0.23 U/kg) and high dose (0.28-0.46 U/kg). The cessation of active bleeding was noted by clinical observation or hematocrit determination. The degree of elevation of the circulating platelets tended to vary inversely to the degree of shock and directly to the amounts of platelets infused. The survival of transfused platelets was very short in shock cases, about few hours to one day. This may be due to many factors: platelet plug to injured vessels, immune complex reaction, trapping of platelets to the poor circulation area, rapid utilization and destruction of platelets by injured vessels or virus and slow circulation promoting platelet adhesion.