dilutional thrombocytopaenia

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Stored blood is subject to considerable loss of functional platelets and labile coagulation factors - e.g. Factors II, V and VII - but not fibrinogen or Factors II, VII, IX, X and XI.

Large volume transfusion of such blood may result in:

dilutional thrombocytopenia
disseminated intravascular coagulopathy - often attributed to the underlying or associated conditions
impaired platelet function

Laboratory investigations reveal:

increased PT, APTT, bleeding time
reduced plasma levels of fibrinogen, Factors V and VIII
thrombocytopenia

Management:

review patient's clinical condition; underlying disease; presence of anatomical bleeding lesions; results of coagulation tests
consider fresh frozen plasma - which contains the plasma proteins and labile clotting factors
consider cryoprecipitate - rich in Factor VIII and fibrinogen - especially if DIC is evident as fibrinogen is required in addition to clotting factors

Last reviewed 01/2018

Links:

disseminated intravascular coagulation

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dilutional thrombocytopaenia