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In hematology, thrombocythemia is a condition of high platelet (thrombocyte) count in the blood. Normal count is in the range of 150 × 10 9 to 450 × 10 9 platelets per liter of blood, [1] but investigation is typically only considered if the upper limit exceeds 750 × 10 9 /L.
Platelet count increase as well as platelet survival after transfusion is related to the dose of platelets infused and to the patient's body surface area (BSA). Usually these values are less than what would be expected. Corrected platelet count increment (CCI) = platelet increment at one hr x BSA (m 2) / # platelets infused x 10 11
This results in platelet activation and the formation of platelet microparticles, which initiate the formation of blood clots; the platelet count falls as a result, leading to thrombocytopenia. [1] [7] In addition, the reticuloendothelial system (mostly the spleen) removes the antibody-coated platelets, further contributing to the thrombocytopenia.
Low levels of platelets in turn may lead to prolonged or excessive bleeding. It is the most common coagulation disorder among intensive care patients and is seen in a fifth of medical patients and a third of surgical patients. [3] A normal human platelet count ranges from 150,000 to 450,000 platelets/microliter (μL) of blood. [4]
Platelet concentration in the blood (i.e. platelet count), can be measured manually using a hemocytometer, or by placing blood in an automated platelet analyzer using particle counting, such as a Coulter counter or optical methods. [47] Most common blood testing methods include platelet count in their measurements, usually reported as PLT. [48]
Higher platelet transfusion thresholds have been used in premature neonates, but this has been based on limited evidence. [19] There is now evidence that using a high platelet count threshold (50 x 10 9 /L) increases the risk of death or bleeding compared to a lower platelet count threshold (25 x 10 9 /L) in premature neonates. [20]
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