Thrombocytopenia in intensive care unit: is it related to acquired pneumonia?

Abstract

One of the most common infections in mechanically ventilated patients in the intensive care unit is acquired pneumonia, which has a considerable mortality and morbidity. Low platelet count is considered one of the most common laboratory abnormal finding in ICU, and in this study we are trying to correlate it with ICU acquired pneumonia (ICUAP). We reviewed the data of 41 mechanically ventilated ICU patients, including the date of ICUAP, platelet count on admission, etiologic factors and pathogens, the nadir value within seven days before and after the date of ICUAP, development of low platelets (platelets <100x1.03/mm³), acute physiology and chronic health evaluation (APACHE II) scores on admission, the medications especially those that might affect the platelet count and the rest of laboratory fifteen out of 41 patients had thrombocytopenia during their stay in the ICU at least once, with higher mortality rates than non-thrombocytopenic group (mortality rates of 80% and 50% respectively, p<0.05). The meantime for the first ICUAP was noticed on 13±10.3 days from admission. The nadir platelets count associated with ICUAP was noticed on 12±11.3th day from admission with 30% fall when compared to the count on admission (platelet count of 157.2±87.4x10³mm³, 224.1±106.3x10³/mm³ respectively p<0.001). Thrombocytopenia can be an early sign for severe infection in the ICU such as ICUAP, and has an important impact on prognosis.

Keywords: intensive care unit (ICU), acquired pneumonia, thrombocytopenia, ventilator acquired pneumonia (VAP)

Mary Slessor Journal of Medicine Vol. 5(2) 2005: 17-20