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This article is part of a series on Translational Research, edited by Dr John Kellum.

Review

Bench-to-bedside review: Thrombocytopenia-associated multiple organ failure – a newly appreciated syndrome in the critically ill

Trung C Nguyen1 and Joseph A Carcillo2 email

Texas Children's Hospital, 6621 Fannin St MC2-3450, Houston, TX 770330, USA

Division CCM, 6th Floor, Children's Hospital of Pittsburgh, 3705 5th Avenue, Pittsburgh PA 15213, USA

author email corresponding author email

Critical Care 2006, 10:235doi:10.1186/cc5064

Published: 3 November 2006

Abstract

New onset thrombocytopenia and multiple organ failure (TAMOF) presages poor outcome in critical illness. Patients who resolve thrombocytopenia by day 14 are more likely to survive than those who do not. Patients with TAMOF have a spectrum of microangiopathic disorders that includes thrombotic thrombocytopenic purpura (TTP), disseminated intravascular coagulation (DIC) and secondary thrombotic microanigiopathy (TMA). Activated protein C is effective in resolving fibrin-mediated thrombosis (DIC); however, daily plasma exchange is the therapy of choice for removing ADAMTS 13 inhibitors and replenishing ADAMTS 13 activity which in turn resolves platelet: von Willebrand Factor mediated thrombosis (TTP/secondary TMA).


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