Transfusion Requirement in Children with Dengue Virus Infection

บทคัดย่อ

Abstract :

A retrospective study of transfusion requirement in 694 children with dengue fever (DF, n=229) and dengue hemorrhagic fever (DHF, n=465) from July 2000 to December 2007 was conducted. Their median age was 11 years. The patients were divided into two groups: group 1 (n=68) included patients with risk factors such as morbid obesity or ibuprofen ingestion that were associated with the more severe clinical manifestation or bleeding tendency, and group 2 (n=626) included patients without risk factors. The results revealed that the overall transfusion requirement was 7.1% (49/694). Patients with risk factors required a higher transfusion rate (48.5%) compared with patients without risk factors (2.5%) with a p value of < 0.0001. Patients with risk factors requiring transfusion varied from DF to different grades of DHF while those without risk factors requiring transfusion included only DHF grades III and IV. Patients requiring transfusion had more frequent bleeding episodes and lower hematocrits compared with those not requiring. However, the platelet counts of both groups were similar ranging from 20,000 to 60,000/mL. Moreover, the ratio of crossmatch to transfusion of blood components among patients with risk factors (1.5:1) was lower than those without risk factors (3:1). Importantly, the ratio of crossmatch to transfusion of platelet concentrate among both groups was similar at 1:1. Finally, the additional requirement of recombinant activated factor VII was 2.4% (17/694) including DHF grades III and IV exhibiting massive uncontrolled bleeding episodes. Eleven patients survived while six patients died. The overall case-fatality rate was 0.86% (6/694).