Bench-to-bedside review: thrombocytopenia-associated multiple organ failure--a newly appreciated syndrome in the critically ill.
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).
Nguyen
Trung C
TC
Texas Children's Hospital, 6621 Fannin St MC2-3450, Houston, TX 770330, USA.
Carcillo
Joseph A
JA
D016638:Critical Illness; D006801:Humans; D009102:Multiple Organ Failure / Q000150:complications / Q000209:etiology*; D010951:Plasma Exchange; D011379:Prognosis; D011486:Protein C / Q000627:therapeutic use; D013577:Syndrome; D013921:Thrombocytopenia / Q000150:complications* / Q000209:etiology*
D011486:Protein C