Effect of Platelet Transfusion on Clot Strength in Dengue Fever with Thrombocytopenia Related Bleeding: A Thromboelastography-Based Study

Abstract

Platelet transfusions are often administered in dengue illness complicated by thrombocytopenia-related bleeding. However, whether this practice results in an improvement of clot strength is not clear. This study assessed the impact of platelet transfusion on the control of bleeding and improvement in clot strength as assessed by thromboelastography among 74 patients with dengue. The effect of either weight-based random donor platelets or 1 unit of single donor aphaeresis units was studied. Transfusion of weight-based random donor platelets resulted in a mean platelet count increase of 10,210 cells per mm3 at 24 h from pretransfusion values, which reached marginal statistical significance (p = 0.031). Patients who received single donor platelets achieved a mean platelet increment of 22,874 cells per mm3 at 24 h, and the difference observed had a high statistical significance (p < 0.001). However, no significant improvement in clot strength was observed in thromboelastography. The mean increment in maximum amplitude value at 24 h was only 2 mm in the random donor platelet group and 5 mm in the single donor group, both of which did not reach statistical significance. Furthermore, the majority of patients had ongoing bleeding despite the administration of platelets. This study observed that platelet transfusion in dengue patients with bleeding complication improved the absolute platelet count with no improvement in clot strength.