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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;