The Internet Book of Critical Care Podcast IBCC Episode 22 - Thrombocytopenia
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Jan 31, 2019 Approach to low platelets in ICU patients, diagnostic considerations for thrombocytopenia, misconceptions about HIT diagnosis, management of different patient groups, indications and contraindications for platelet transfusions
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Assess Platelet Levels Thoughtfully
- Check platelet count severity and the clinical context before ordering extensive workups in ICU thrombocytopenia.
- Mild thrombocytopenia in sepsis may track illness, so focus on trends and clinical severity.
Thrombocytopenia Categories Explained
- Thrombocytopenia causes differ by timing: chronic, non-immune gradual drops, and immune sudden drops.
- ICU thrombocytopenia etiologies often involve complex conditions like TTP, DIC, HLH, or device-related consumption.
Beware Pseudo-thrombocytopenia Artifacts
- Always consider pseudo-thrombocytopenia caused by EDTA-induced platelet clumping when platelet count is low.
- Confirm by repeating CBC using a citrate (blue top) tube to avoid false thrombocytopenia.