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• W2078651432 abstract "Thrombocytopenia is a common occurrence in intensive care unit (ICU) patients, with incidence rates ranging from 13% to nearly 60% in recent published series. 1 Priziola J.L. Smythe M.A. Dager W.E. Drug-induced thrombocytopenia in critically ill patients. Crit Care Med. 2010; 38: S145-S154 Crossref PubMed Scopus (51) Google Scholar , 2 Hanes S.D. Quarled D.A. Boucher B.A. Incidence and risk factors of thrombocytopenia in critically ill trauma patients. Ann Pharmacother. 1997; 31: 285-289 PubMed Google Scholar , 3 Cawley M.J. Wittbrodt E.T. Boyce E.G. et al. Potential risk factors associated with thrombocytopenia in a surgical intensive care unit. Pharmacotherapy. 1999; 19: 108-113 Crossref PubMed Scopus (51) Google Scholar , 4 Strauss R. Wehler M. Mehler K. et al. Thrombocytopenia in patients in the medical intensive care unit: bleeding prevalence, transfusion requirements and outcome. Crit Care Med. 2002; 30: 1765-1771 Crossref PubMed Scopus (272) Google Scholar , 5 Hui P. Cook D.J. Lim W. et al. The frequency and clinical significance of thrombocytopenia complicating critical illness: a systematic review. Chest. 2011; 139: 271-278 Crossref PubMed Scopus (197) Google Scholar Although there is some variability in the incidence of thrombocytopenia based on ICU and patient demographics (less in pediatric and surgical patients when compared to adults and medical ICU patients), published reports encompass patients from diverse parts of the world and in all types of ICUs and describe a truly universal occurrence. Although many of these critically ill patients will demonstrate thrombocytopenia on admission to the ICU, for the vast majority, thrombocytopenia is not the primary cause, or even a substantial cause, for that admission. However, of those patients who do not exhibit thrombocytopenia at the time of ICU admission, many will develop thrombocytopenia while in the ICU. 5 Hui P. Cook D.J. Lim W. et al. The frequency and clinical significance of thrombocytopenia complicating critical illness: a systematic review. Chest. 2011; 139: 271-278 Crossref PubMed Scopus (197) Google Scholar Although thrombocytopenia clearly increases the risk for bleeding, both spontaneous and resulting from invasive procedures, and results in higher mortality and greater morbidity in ICU patients, 4 Strauss R. Wehler M. Mehler K. et al. Thrombocytopenia in patients in the medical intensive care unit: bleeding prevalence, transfusion requirements and outcome. Crit Care Med. 2002; 30: 1765-1771 Crossref PubMed Scopus (272) Google Scholar the presence of thrombocytopenia may also alert intensivists to possible underlying causes for their patients' critical illness, or to developing complications resulting from their treatment. Consequently, an understanding of the possible causes and clinical significance of thrombocytopenia is essential to good ICU care. KEY POINTS •The development or worsening of thrombocytopenia following ICU admission is an indicator of poor prognostic risk. •Scoring systems for HIT are best at identifying those patients at low risk for HIT. •Over diagnosis of HIT results in increased hospital length of stay, cost and morbidity. Platelet injury assays are best at identifying those patients who have HIT as a consequence warrant a change in anticoagulant therapy. •Drugs frequently employed in critically-ill patients are a common cause of thrombocytopenia in the ICU. •Sepsis can cause thrombocytopenia by increased platelet destruction and/or decreased platelet production. •The development or worsening of thrombocytopenia following ICU admission is an indicator of poor prognostic risk. •Scoring systems for HIT are best at identifying those patients at low risk for HIT. •Over diagnosis of HIT results in increased hospital length of stay, cost and morbidity. Platelet injury assays are best at identifying those patients who have HIT as a consequence warrant a change in anticoagulant therapy. •Drugs frequently employed in critically-ill patients are a common cause of thrombocytopenia in the ICU. •Sepsis can cause thrombocytopenia by increased platelet destruction and/or decreased platelet production." @default.
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• W2078651432 date "2012-07-01" @default.
• W2078651432 modified "2023-10-17" @default.
• W2078651432 title "Etiology and Significance of Thrombocytopenia in Critically Ill Patients" @default.
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• W2078651432 doi "https://doi.org/10.1016/j.ccc.2012.04.007" @default.
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