Running head: REFRACTORINESS TO PLATELET TRANSFUSION Management of Patients Refractory to Platelet Transfusion [Author’s Name] [Class] 04 August 2011 Abstract How to manage patients refractory to platelet transfusion is a difficult question…
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Keywords: platelet transfusion, refractoriness, refractory, management. Management of Patients Refractory to Platelet Transfusion How to manage patients refractory to platelet transfusion is a continued debate. Much has been written and said about possible ways to resolve this clinical issue. Despite a wealth of literature on the topic, patient refractoriness to platelet transfusion remains a serious medical challenge. Patients refractory to platelet transfusion require special treatment and complex strategies to preserve and improve their health. It should be noted, that the current state of literature does not provide a single, universal response to the refractoriness problem. Different techniques of managing patients refractory to platelet transfusion have been used, at various degrees of success. Given the risks presented by refractoriness and high rates of platelet transfusion failures, there is the need for new clinical assessment protocols, which will assist in providing patients with adequate care, with little to no risks to their health. Refractoriness to Platelet Transfusion: What Is It? The past years were marked with increased attention to the problem of refractoriness to platelet transfusion in different groups of patients. ...
cally, nearly 30% of oncohematologic patients are refractory to platelet transfusion, which makes it particularly difficult to improve their health (Ferreira et al, 2011). Generally, being refractory to platelet transfusion is essentially about having posttransfusion platelet count increments progressively decreased (Sandler, 1998). Diminished clinical responses to platelet transfusion is just another sign of refractoriness and a situation, which can become life-threatening, if platelet counts are lower than 10,000/?L (Sandler, 1998; Zeigler et al, 1987). The state of refractoriness in patients is usually determined by measuring “the corrected platelet count increment 1-hour after a platelet transfusion” (Sandler, 1998, p.2). Also, clinicians can easily define refractoriness by using uncorrected platelet transfusion count increments (Sandler, 1998). For example, a 75-kg patient receiving one unit of random donor platelet concentrate must experience an increase in platelet count equal to 5-6X109 (Sandler, 1998). Failure to achieve this result suggests the presence of refractoriness and requires developing other, unique methods of managing such patients. Refractoriness to Platelet Transfusion: Causes and Implications for Management The main causes of refractoriness to platelet transfusion are usually categorized as immune and non-immune. “Non-immune causes of refractoriness include but are not limited to fever, hypersplenism, infection, amphotericin B treatment, disseminated intravascular coagulation, and even venoclusive disease” (Sandler, 1998). These are the most usual predictors of low platelet count increments following platelet transfusion in patients, and it is no wonder that concerted effort are made to reduce the risks of failures in platelet
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