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The critically ill in hematologic problems: Part 2

(BQ) Continued part 1, part 2 of the document The critically ill in hematologic problems has contents: The critically ill patient with abnormal platelet count, drugs and blood cells, adverse transfusion reactions in critically ill patients. Invite you to refer. | Chapter 6 The Critically Ill Patient with Abnormal Platelet Count Luca G. Mascaretti and Paola Pradella Abnormal platelet counts are a common finding in critically ill patients. Whereas thrombocytopenia defined as a platelet count less than 150 109 L affects 13-60 of Intensive Care Unit ICU patients 1 and has been extensively studied the occurrence of thrombocytosis platelet counts 400 109 L is observed less frequently and has not been studied to the same extent. In this chapter the main causes of thrombocytopenia and thrombocytosis in critically ill patients will be illustrated and their implications on morbidity and mortality will be discussed. Due to its importance in the ICU setting a section in this chapter will be dedicated to heparin-induced thrombocytopenia HIT . L.G. Mascaretti MD El Transfusion Medicine Department University Hospital Trieste Strada di Fiume 447 Trieste 34149 Italy e-mail luca.mascaretti@aots.sanita.fvg.it P. Pradella MSc Hemostasis and Blood Coagulation Laboratory Transfusion Medicine Department University Hospital Trieste Strada di Fiume 447 Trieste 34149 Italy e-mail paola.pradella@aots.sanita.fvg.it G. Berlot G. Pozzato eds. Hematologic Problems in the Critically III 59 DOI 10.1007 978-88-470-5301-4_6 Springer-Verlag Italia 2015 60 L.G. Mascaretti and P. Pradella 6.1 Thrombocytopenia A Classification Before addressing the issues related to true thrombocytopenia pseudo or spurious thrombocytopenia must be defined. In some conditions such as liver diseases neoplasia autoimmune disease or in healthy subjects antibodies mediated by anticoagulants such as EDTA are responsible for platelet clumping which not being detected by cell counters will lead to falsely low platelet counts 2 . Pseudothrombocytopenia is not clinically significant and is diagnosed by microscopic examination of the blood smear Fig. 6.1 and by repeating the whole blood count in tubes with a different anticoagulant heparin- or citrate-based solutions . True .