HEMATOLOGY AND

COAGULATION
Anemia in the Intensive Care Unit
• Anemia is a common problem among critically ill patients.According
to the World Health Organization, anemia is clinically defined as an
Hgb concentration less than or equal to 12 g/dL for women and 13
g/dL for men.
Anemia is potentially deleterious because lower Hgb levels decrease
oxygen carrying capacity of the blood and may reduce tissue
oxygenation
• Anemia in the Neurocritical Care Unit
• Anemia is common in the NCCU and, depending on the definition,
• occurs in nearly 40% of patients.28 It has been identified
• as an independent factor associated with death or severe
• disability in several disorders including subarachnoid hemorrhage
• (SAH), particularly in patients who develop delayed
• cerebral ischemia, traumatic brain injury (TBI), or intracerebral
• hemorrhage (ICH).28-34 However, there remains variation
• in how anemia is managed.
• Thrombocytopenia
• Thrombocytopenia in the Critically Ill
• The importance of platelets and their role in thrombus formation is clear,
but their significance in sepsis is being elucidated.Thrombocytopenia
occurs in 13% to 58% of ICU patients; 23% have at least one platelet count
less than 100,000/mm3 and 10% had counts less than 50,000 mm
• Sepsis is considered the major independent risk factor for
thrombocytopenia in the ICU
• Other factors associated with thrombocytopenia are episodes of bleeding
or transfusion,longer ICU stays, and Acute Physiology and Chronic Health
Evaluation II (APACHE II) scores greater than 15.
• ICU-related thrombocytopenia is primarily caused by peripheral loss,
destruction, and margination of platelets rather than bone marrow
hypoplasia or nutritional deficiency.
• Sepsis accounts for 48% of cases. Other causes include liver disease,
hypersplenism, consumption, platelet destruction,DIC, medications,
immune phenomena, and intravascular devices