title: Prophylactic platelets in dengue: survey responses highlight lack of an evidence base.
abstract: 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.
authors: Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom. james.whitehorn@lshtm.ac.uk
authors: James
authors: J
authors: Whitehorn
authors: Rosmari
authors: R
authors: Rodriguez Roche
authors: Maria G
authors: MG
authors: Guzman
authors: Eric
authors: E
authors: Martinez
authors: Wilmar Villamil
authors: WV
authors: Gomez
authors: Leonard
authors: L
authors: Nainggolan
authors: Ida Safitri
authors: IS
authors: Laksono
authors: Ajay
authors: A
authors: Mishra
authors: Lucy
authors: L
authors: Lum
authors: Abul
authors: A
authors: Faiz
authors: Amadou
authors: A
authors: Sall
authors: Joshua
authors: J
authors: Dawurung
authors: Alvaro
authors: A
authors: Borges
authors: Yee-Sin
authors: YS
authors: Leo
authors: Lucille
authors: L
authors: Blumberg
authors: Daniel G
authors: DG
authors: Bausch
authors: Axel
authors: A
authors: Kroeger
authors: Olaf
authors: O
authors: Horstick
authors: Guy
authors: G
authors: Thwaites
authors: Heiman
authors: H
authors: Wertheim
authors: Mattias
authors: M
authors: Larsson
authors: Tran Tinh
authors: TT
authors: Hien
authors: Rosanna
authors: R
authors: Peeling
authors: Bridget
authors: B
authors: Wills
authors: Cameron
authors: C
authors: Simmons
authors: Jeremy
authors: J
authors: Farrar
mesh_terms: D000293:Adolescent; D000328:Adult; D001792:Blood Platelets; D003715:Dengue / Q000150:complications* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017713:Platelet Transfusion / Q000379:methods*; D011795:Surveys and Questionnaires; D013921:Thrombocytopenia / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult