Thrombocytopenia in Critically Ill Patients

被引:110
作者
Levi, Marcel [1 ]
Lowenberg, Ester C. [1 ]
机构
[1] Univ Amsterdam, Acad Med Ctr F4, Dept Internal Med, NL-1105 AZ Amsterdam, Netherlands
关键词
Platelets; coagulation; intensive care; sepsis; thrombotic microangiopathy; immune thrombocytopenia;
D O I
10.1055/s-0028-1092871
中图分类号
R5 [内科学];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
Critically ill patients often have a low platelet count. A proper identification of the underlying cause of this abnormality is required, because various underlying disorders may necessitate different diagnostic and therapeutic management strategies. Platelets are part of the first line of defense of the body against bleeding, hence, thrombocytopenia may increase the risk of hemorrhage. In case of systemic inflammatory syndromes, such as the response to sepsis, disseminated intravascular platelet activation may occur, which will contribute to microvascular failure and thereby play a role in the development of organ dysfunction. A low platelet count is a strong and independent predictor of an adverse outcome in critically ill patients, thereby facilitating a simple and practical risk assessment in these patients and potentially guiding the use of complex or expensive treatment strategies.
引用
收藏
页码:417 / 424
页数:8
相关论文
共 57 条
[1]
Time course of platelet counts in critically ill patients [J].
Akca, S ;
Haji-Michael, P ;
de Mendonça, A ;
Suter, P ;
Levi, M ;
Vincent, JL .
CRITICAL CARE MEDICINE, 2002, 30 (04) :753-756
[2]
Ultralarge multimers of von Willebrand factor form spontaneous high-strength bonds with the platelet glycoprotein Ib-IX complex:: studies using optical tweezers [J].
Arya, M ;
Anvari, B ;
Romo, GM ;
Cruz, MA ;
Dong, JF ;
McIntire, LV ;
Moake, JL ;
López, JA .
BLOOD, 2002, 99 (11) :3971-3977
[3]
Prospective validation of the International Society of Thrombosis and Haemostasis scoring system for disseminated intravascular coagulation [J].
Bakhtiari, K ;
Meijers, JCM ;
de Jonge, E ;
Levi, M .
CRITICAL CARE MEDICINE, 2004, 32 (12) :2416-2421
[4]
THROMBOCYTOPENIA IN THE INTENSIVE-CARE UNIT [J].
BAUGHMAN, RP ;
LOWER, EE ;
FLESSA, HC ;
TOLLERUD, DJ .
CHEST, 1993, 104 (04) :1243-1247
[5]
Activation of sickle red blood cell adhesion via integrin-associated protein/CD47-induced signal transduction [J].
Brittain, JE ;
Mlinar, KJ ;
Anderson, CS ;
Orringer, EP ;
Parise, LV .
JOURNAL OF CLINICAL INVESTIGATION, 2001, 107 (12) :1555-1562
[6]
ACTIVATION OF THE COAGULATION CASCADE IN SEVERE FALCIPARUM-MALARIA THROUGH THE INTRINSIC PATHWAY [J].
CLEMENS, R ;
PRAMOOLSINSAP, C ;
LORENZ, R ;
PUKRITTAYAKAMEE, S ;
BOCK, HL ;
WHITE, NJ .
BRITISH JOURNAL OF HAEMATOLOGY, 1994, 87 (01) :100-105
[7]
The platelet collagen receptor glycoprotein VI is a member of the immunoglobulin superfamily closely related to FcαR and the natural killer receptors [J].
Clemetson, JM ;
Polgar, J ;
Magnenat, E ;
Wells, TNC ;
Clemetson, KJ .
JOURNAL OF BIOLOGICAL CHEMISTRY, 1999, 274 (41) :29019-29024
[8]
Clemetson KJ, 2001, THROMB HAEMOSTASIS, V86, P189
[9]
Treatment effects of drotrecogin alfa (activated) in patients with severe sepsis with or without overt disseminated intravascular coagulation [J].
Dhainaut, JF ;
Yan, SB ;
Joyce, DE ;
Pettilä, V ;
Basson, B ;
Brandt, JT ;
Sundin, DP ;
Levi, M .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2004, 2 (11) :1924-1933
[10]
Platelets release thrombopoietin (Tpo) upon activation: another regulatory loop in thrombocytopoiesis? [J].
Folman, CC ;
Linthorst, GE ;
van Mourik, J ;
van Willigen, G ;
de Jonge, E ;
Levi, M ;
de Haas, M ;
von dem Borne, AEGK .
THROMBOSIS AND HAEMOSTASIS, 2000, 83 (06) :923-930