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Dilutional low platelets

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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