Platelets Disorders in ICUPatients

Abstract

Coagulation disorders are common among intensive care patients and may range from isolated thrombocytopenia or prolonged global clotting tests to complex defects, such as disseminated intravascular coagulation. There are many causes for coagulation disorders and each of these underlying disorders may require specific therapeutic management. Hence, a proper differential diagnosis and the initiation of adequate treatment strategies are crucial to reduce morbidity and mortality in critically ill patients with coagulation abnormality. Activated platelets secrete numerous compounds from their alpha granules, dense granules, lysosomes and cytoplasmic stores, all contributing to platelet adhesion, aggregation and modulation of endothelial function and inflammatory processes. Nowadays, platelets are considered vital to host immunity. In intensive care unit, approximately 40% of the patients develop thrombocytopenia, and INR is increased in 30%. Disturbed coagulation and its consequences may lead to organ dysfunction. Conclusion: thrombocytosis or thrombocytothemia is a condition characterized by the presence of elevated platelet count in blood. One must first distinguish reactive from primary thrombocytosis. The presence of acute or subacute infection, a connective tissue disorder, vasculitis, hemolysis, active bleeding, recent surgery, history of splenectomy, or iron deficiency anaemia favors the diagnosis of reactive thrombocytosis. Keywords: platelets disorders, thrombocytosis; thrombocytopenia.