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Differential diagnosis of thrombocytopaenia in critically ill patients


Authors: J. Gumulec 1;  R. Kula 2;  O. Šimetka 3;  L. Pleva 4;  J. Ullrychová 5
Authors‘ workplace: Ústav klinické hematologie FN Ostrava, přednosta prim. MUDr. Jaromír Gumulec 1;  Anesteziologicko‑resuscitační klinika FN Ostrava, přednosta prim. MUDr. Jan Jahoda 2;  Porodnicko‑gynekologická klinika FN Ostrava, přednosta prim. MUDr. Ondřej Šimetka 3;  Traumatologické centrum FN Ostrava, přednosta prim. doc. MUDr. Leopold Pleva, CSc. 4;  Oddělení laboratoří a transfuzní služby Nemocnice Děčín, o. z., přednostka prim. MUDr. Jana Ullrychová 5
Published in: Vnitř Lék 2010; 56(Supplementum 1): 14-26
Category: 16th Parizek's Days, Ostrava-Poruba, March 25th –26th 2010

Overview

Many critically ill patients develop hemostatic abnormalities, ranging from isolated thrombocytopenia to complex defects, such as disseminated intravascular coagulation. New onset thrombocytopenia and multiple organ failure predicts poor outcome in critical illness. There are many causes for platelet count decline in critically ill patients and each of these may require specific therapeutic and supportive management. In recent years, new insights into the pathogenesis and clinical management of many hemostatic defects in critically ill patients have been accumulated and this knowledge is helpful in determining the optimal diagnostic and differential diagnostic strategy.

Key words:
thrombocytopenia – shock – sepsis – disseminated intravascular coagulation – drug induced thrombocytopenia – immune thrombocytopenia – intensive care unit


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