
Contents
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Bleeding disorders Bleeding disorders
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Acquired bleeding disorders Acquired bleeding disorders
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Dilutional coagulopathy Dilutional coagulopathy
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Disseminated intravascular coagulopathy Disseminated intravascular coagulopathy
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Patients on anticoagulation therapy Patients on anticoagulation therapy
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Enteral Enteral
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Parenteral Parenteral
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Liver disease Liver disease
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Renal failure Renal failure
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Thrombocytopenia Thrombocytopenia
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Idiopathic thrombocytopenic purpura (ITP) Idiopathic thrombocytopenic purpura (ITP)
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Heparin-induced thrombocytopenia Heparin-induced thrombocytopenia
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Consumptive thrombocytopenia Consumptive thrombocytopenia
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Drug-related thrombocytopenia Drug-related thrombocytopenia
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Bone marrow failure syndromes Bone marrow failure syndromes
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Mechanical thrombocytopenia Mechanical thrombocytopenia
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Acquired haemophilia Acquired haemophilia
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Acquired von Willebrand syndrome Acquired von Willebrand syndrome
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Inherited bleeding disorders Inherited bleeding disorders
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Haemophilia A and B Haemophilia A and B
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Von Willebrand disease Von Willebrand disease
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Platelet function disorders Platelet function disorders
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Other factor deficiencies Other factor deficiencies
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Collagen disorders Collagen disorders
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Anaemia in critical care Anaemia in critical care
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Definition Definition
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Pathogenesis Pathogenesis
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Consequences of anaemia Consequences of anaemia
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Approach to the investigation of anaemia Approach to the investigation of anaemia
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Management of anaemia in critical care Management of anaemia in critical care
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Measures to minimize blood loss in the ICU Measures to minimize blood loss in the ICU
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Erythropoietin Erythropoietin
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Conclusion Conclusion
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Sickle cell anaemia Sickle cell anaemia
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Pathogenesis Pathogenesis
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Clinical approach Clinical approach
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Examination Examination
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Investigations Investigations
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Management ‘general principles’ Management ‘general principles’
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Transfusion in sickle cell anaemia, including hyperhaemolysis Transfusion in sickle cell anaemia, including hyperhaemolysis
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The acute chest syndrome The acute chest syndrome
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Pulmonary hypertension in SCD Pulmonary hypertension in SCD
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Surgery Surgery
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Conclusion Conclusion
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Haemolysis Haemolysis
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General approach to haemolysis General approach to haemolysis
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Haemolytic conditions particularly relevant to critical care Haemolytic conditions particularly relevant to critical care
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G6PD deficiency G6PD deficiency
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Immune haemolysis Immune haemolysis
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Alloimmune haemolysis Alloimmune haemolysis
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Autoimmune haemolysis Autoimmune haemolysis
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Non-immune Non-immune
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TTP TTP
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Disseminated intravascular coagulation Disseminated intravascular coagulation
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Pathogenesis of DIC Pathogenesis of DIC
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Neutropenic sepsis Neutropenic sepsis
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Definitions Definitions
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The clinical problem The clinical problem
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A systematic approach A systematic approach
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History History
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Examination Examination
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Investigations Investigations
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Initial empirical treatment Initial empirical treatment
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Infection control measures Infection control measures
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Persistent fever or inadequate clinical response Persistent fever or inadequate clinical response
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When to de-escalate or stop antibacterial therapy When to de-escalate or stop antibacterial therapy
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Fungal infections Fungal infections
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Empirical antifungal therapy Empirical antifungal therapy
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Viral infections Viral infections
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Antiviral therapy Antiviral therapy
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Granulocyte-colony stimulating factor Granulocyte-colony stimulating factor
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Granulocytes for neutropenia Granulocytes for neutropenia
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Conclusion Conclusion
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Haematological malignancies in the ICU Haematological malignancies in the ICU
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Neutropenia and neutropenic sepsis Neutropenia and neutropenic sepsis
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Tumour lysis syndrome Tumour lysis syndrome
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Hyperviscosity syndromes Hyperviscosity syndromes
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Hyperleukocytosis Hyperleukocytosis
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Haemorrhagic complications Haemorrhagic complications
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Mechanical vascular and/or airway obstruction Mechanical vascular and/or airway obstruction
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Chemotherapy-induced toxicity Chemotherapy-induced toxicity
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HCT HCT
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Sepsis and acute respiratory failure Sepsis and acute respiratory failure
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GvHD GvHD
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Graft failure Graft failure
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Veno-occlusive disease Veno-occlusive disease
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Principles of ICU management Principles of ICU management
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Antibiotics and sepsis management Antibiotics and sepsis management
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G-CSF G-CSF
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Corticosteroids Corticosteroids
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Calcineurin inhibitors and other immunosuppressive agents Calcineurin inhibitors and other immunosuppressive agents
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Blood product administration Blood product administration
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Urgent chemotherapy Urgent chemotherapy
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Coagulation monitoring Coagulation monitoring
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Standard coagulation testing Standard coagulation testing
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Fibrinogen Fibrinogen
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D-dimer D-dimer
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Additional tests Additional tests
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Point-of-care testing Point-of-care testing
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Thromboelastogram trace interpretation Thromboelastogram trace interpretation
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Anticoagulant monitoring Anticoagulant monitoring
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Warfarin Warfarin
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DOACs DOACs
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LMWH LMWH
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UFH UFH
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Fondaparinux Fondaparinux
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Argatroban Argatroban
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Multiple choice questions and further reading Multiple choice questions and further reading
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Cite
Abstract
This chapter discusses haematological disorders and includes discussion on bleeding disorders (including acquired bleeding disorders and inherited bleeding disorders), anaemia in critical care (including discussion on pathogenesis, consequences of anaemia, approach to the investigation of anaemia, classification of anaemia, measures to minimize blood loss in the intensive care unit [ICU], and erythropoietin). It also covers sickle cell anaemia (transfusion in sickle cell anaemia, including hyperhaemolysis, acute chest syndrome, and pulmonary hypertension in sickle cell disease), haemolysis (haemolytic conditions particularly relevant to critical care), disseminated intravascular coagulation, neutropenic sepsis (including persistent fever or inadequate clinical response, fungal infections, empirical antifungal therapy, viral infections, granulocyte-colony stimulating factor, and granulocytes for neutropenia). Finally, the chapter discusses haematological malignancies in the ICU (neutropenia and neutropenic sepsis, tumour lysis syndrome, hyperviscosity syndromes, hyperleukocytosis, haemorrhagic complications, haematopoietic stem cell transplant, graft versus host disease, and corticosteroids) and coagulation monitoring.
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