Health & Fitness

NEW TEST AT SIR GANGA RAM HOSPITAL HELPS REDUCE DENGUE TREATMENT COST

sarkarimirror

NEW TEST AT SGRH HELPS REDUCES DENGUE TREATMENT COST

HELS AVOID PLATELET TRANSFUSION

REDUCES COST BY Rs 15-25,000

 

LATEST  TECHNIQUE OF IPF (IMMATURE PLATELET FRACTION)  TESTING IN DENGUE PATIENTS WITH LOW PLATELET COUNT  EVALUATED BY HEMATOLOGY DEPARTMENT AT SGRH SHOWS POSITIVE RESULTS :

  1. COST OF TREATMENT FOR SERIOUSLY ILL DENGUE PATIENT WITH LOW PLATELET COUNT WILL REDUCE SIGNIFICANTLY

 

  1. PLATELET TRANSFUSION RELATED HAZARDS CAN BE AVOIDED

 

  1. INCREASING IPF PERCENTAGE WILL HELP PREDICT THE TIME PERIOD IN WHICH PLATELETS WILL INCREASE ON ITS OWN WITOUT PLATELET TRANSFUSION

 

  1.  LOW IPF PERCENTAGE WILL PREDICT FURTHER FALL OF PLATELET COUNT AND  THE NEED FOR IMMEDIATE PLATELET TRANSFUSION

 

  1. SGRH FOUND IPF AS A IMPORTANT PARAMETER TO PREDICT PLATELET RECOVERY SO THAT PLATELET TRANSFUSION CAN BE AVOIDED

 

Dengue is a mosquito borne viral infection with potential fatal complications . In this season of Dengue , we at Sir Ganga Ram Hospital have seen more than 500 confirmed cases of Dengue in OPD and admitted more than 300 cases in the hospital .

The main haematological abnormalities in dengue are thrombocytopenia and leucopenia. Thrombocytopenia is often symptomatic demanding platelet transfusion. As there is inherent risk associated with platelet transfusion , it is imperative to define precise criteria and transfusion trigger for platelets in Dengue patients .Immature platelets are recently released young platelets from bone marrow of dengue patients . The Immature Platelet Fraction (IPF %) is raised in diseases where there is increased platelet destruction and consumption , as it happens in  case of dengue patients.  It is decreased in bone marrow failure . The IPF % can predict the timing of platelet recovery .

According to Dr Jyoti Kotwal , Chairperson , Department of Haematology and Clinical Pathology , Sir Ganga Ram Hospital , “We have used this diagnostic modality in the paediatric patients of Dengue this season . We found that range of normal IPF at SGRH using 100 normal individuals is 0 to 7.25 %    . Thus if IPF % is more than 7.25 % , it means younger re-generating platelets are present and once it crosses 10 % , it is likely that platelets will increase over next few hours . “

According to Dr Dhiren Gupta , Senior Consultant , Paediatric Intensive Care , Sir Ganga Ram Hospital , “As per the present WHO guidelines platelet transfusion is not indicated in a stable dengue patients even if platelet count is less than 10000 . With the availability of new parameter like IPF , very likely that we can predict rise in platelets in a given dengue patients . This parameter has helped us in avoiding un-necessary platelet transfusion  in few paediatric dengue patients . This is an upcoming marker  which can be further developed .”

In one of the studies done on IPF , it was observed that 93.75 % of patients show platelet recovery within 24-48 hours if the IPF was greater than 10 % ( Int J Lab Hematol. 2014 Oct;36(5);499-504 Evaluation of the immature platelet fraction as an indicator of platelet recovery in dengue patients)

Two Case Studies:

  1. 12 year old female – 6 th day of illness with dropping platelets to 11000 . Child was hemodynamically stable with increasing IPF from 6-12 % . Over next 8 hours , platelet started rising rapidly . In next 12 hours it rose to 22000 . The platelets were kept ready but not transfused . Child was saved and discharged .
  2. 6 year old – 6th day of illness with platelet dropping to 15000 and evidence of bleeding and hypotension . IPF was 4.5 % . Platelet Concentration was immediately transfused . Next 12 hours child became stable and IPF rose to 11 % . Child was saved and discharged .

These are two case  studies highlighting  the importance of IPF .  There are other patients on whom this technique has been tried this dengue season with positive results

Dr Jyoti Kotwal added , “Dengue season calls for platelet transfusion , sometimes inappropriate also . Careful clinical watchand monitoring platelet count may help to group the patients under risk category. Immature Platelet Fraction is a parameter that can be monitored to predict platelet recovery , so that platelet transfusion can be avoided , cost be saved and also the hazards associated with transfusion can also be avoided .It holds a great promise of becoming a reliable  future guide for decisions concerning platelet transfusions”