Thrombocytopenia/Platlet Dysfunction

- See: - Bld Prod Menu / - Platlet Transfusion

- Discussion:
  - manifestations:
          - vessel or platlet abnormalities:
          - these present with petechiae, purpura, or easy bruising;
          - bleeding characteristically occurs superficially (bleeding from mucus membranes or from IV sites);
          - bleeding from scury shows perifolicular hemorrhages, gingival bleeding, and intramuscular hematomas;
    - causes: 
          - dilutional thrombocytopenia after massive RBC transfusion or IV fluid therapy;
                  - treat with platlet transfusions as needed;
                  - transfuse 8 units of platlets for every 10-12 units of pRBC's transfused;
          - von willebrand's dz:
                  - treat with cryoprecipitate or DDAVP;
          - acquired platlet dysfunction:
                  - uremia: w/ uremia try conjugated estrogens;
          - fat embolism
          - medications:
                  - heparins (see heparin induced thrombocytopenia)
                  - quinine
                  - platlet inhibitors
                  - antibiotics: zyvox, sulfa agents (septra), rifampin, vancomycin
                  - sedatives and anticonvulsants
                  - cimetidine

 - Management of Bleeding secondary to Platlet Abnormalities:
    - serious bleeding complicatios:
         - platlets (6-8 units at a time);
         - one unit of platlets will increase platlet count by 1000;
         - check 1hr post platlet count;


Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, September 5, 2012 9:15 pm