PMID- 29871503
OWN - NLM
STAT- MEDLINE
DCOM- 20190923
LR  - 20191210
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 52
IP  - 12
DP  - 2018 Dec
TI  - Evaluation of Thrombocytopenia in Critically Ill Patients Receiving Continuous 
      Renal Replacement Therapy.
PG  - 1204-1210
LID - 10.1177/1060028018779200 [doi]
AB  - BACKGROUND: Continuous renal replacement therapy (CRRT) may be associated with 
      thrombocytopenia in critically ill patients. A confounding factor is concomitant 
      use of unfractionated heparin (UFH) and suspicion for heparin-induced 
      thrombocytopenia (HIT). OBJECTIVE: To determine the impact of CRRT on platelet 
      count and development of thrombocytopenia. METHODS: Retrospective analyses 
      evaluated the intrapatient change in platelet count following CRRT initiation. 
      Critically ill adult patients who received CRRT for at least 48 hours were 
      included. The primary outcome was intrapatient change in platelet count from CRRT 
      initiation through the first 5 days of therapy. Secondary outcomes included 
      thrombocytopenia incidence, identification of concomitant factors associated with 
      thrombocytopenia, and frequency of HIT. RESULTS: 80 patients were included. 
      Median platelet count at CRRT initiation (D0) was 128000/microL (81500-212500/microL), 
      which was higher than those on subsequent post-CRRT days (D1: 104500/microL 
      [63000-166750/microL]; D2: 88500/microL [53500-136750/microL]; D3: 91000/microL 
      [49000-138000/microL]; D4: 93000/microL [46000-134000/microL]; and D5: 76000/microL 
      [45500-151000/microL]; P < 0.05 for all). Twenty-five (35%) patients had 
      thrombocytopenia on CRRT D0 compared with D2 (56.3%), D3 (58.7%), and D5 (59.1%); 
      P < 0.05 for all. Controlling for potential confounders, Sequential Organ Failure 
      Assessment score at the time of CRRT initiation was the only independent factor 
      associated with thrombocytopenia. One (1.3%) patient had confirmed HIT. 
      Conclusion and Relevance: This study is the first to demonstrate serial decreases 
      in platelet count across multiple days after CRRT initiation. These data may 
      provide additional insight to thrombocytopenia development in critically ill 
      patients receiving heparin while on CRRT that is not associated with HIT.
FAU - Droege, Christopher A
AU  - Droege CA
AD  - 1 University of Cincinnati Medical Center, OH, USA.
AD  - 2 University of Cincinnati James L. Winkle College of Pharmacy, OH, USA.
FAU - Ernst, Neil E
AU  - Ernst NE
AD  - 1 University of Cincinnati Medical Center, OH, USA.
AD  - 2 University of Cincinnati James L. Winkle College of Pharmacy, OH, USA.
FAU - Messinger, Nicholas J
AU  - Messinger NJ
AD  - 2 University of Cincinnati James L. Winkle College of Pharmacy, OH, USA.
FAU - Burns, Allison M
AU  - Burns AM
AD  - 1 University of Cincinnati Medical Center, OH, USA.
FAU - Mueller, Eric W
AU  - Mueller EW
AD  - 1 University of Cincinnati Medical Center, OH, USA.
AD  - 2 University of Cincinnati James L. Winkle College of Pharmacy, OH, USA.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20180605
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Critical Illness/*therapy
MH  - Female
MH  - Heparin/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Count/trends
MH  - Renal Replacement Therapy/*adverse effects/trends
MH  - Retrospective Studies
MH  - Thrombocytopenia/*blood/diagnosis/*etiology
MH  - Young Adult
OTO - NOTNLM
OT  - critical care
OT  - dialysis
OT  - hemofiltration
OT  - heparin
OT  - renal failure
OT  - thrombocytopenia
EDAT- 2018/06/07 06:00
MHDA- 2019/09/24 06:00
CRDT- 2018/06/07 06:00
PHST- 2018/06/07 06:00 [pubmed]
PHST- 2019/09/24 06:00 [medline]
PHST- 2018/06/07 06:00 [entrez]
AID - 10.1177/1060028018779200 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2018 Dec;52(12):1204-1210. doi: 10.1177/1060028018779200. Epub 
      2018 Jun 5.