RT Book, Section
A1 Goodnough, Lawrence Tim
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Wood, Lawrence D.H.
SR Print(0)
ID 2293830
T1 Chapter 70. Thrombotic Thrombocytopenic Purpura, Hemolytic Uremia Syndromes, and the Approach to Thrombotic Microangiopathies
T2 Principles of Critical Care, 3e
YR 2005
FD 2005
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071416405
LK accessanesthesiology.mhmedical.com/content.aspx?aid=2293830
RD 2022/05/28
AB The  thrombotic  microangiopathies  (TMAs)  include  the  spectrum  of  thrombotic  thrombocytopenic  purpura  (TTP)  and  hemolytic  uremic  syndromes  (HUS)  as  well  as  related  obstetric  syndromes.The  hallmarks  of  TMA  are  a  microangiopathic  hemolytic  anemia  (MAHA)  and  thrombocytopenia.TMA  must  be  distinguished  from  other  coagulopathies,  such  as  disseminated  intravascular  coagulation  (DIC)  and  collagen  vascular  disease  with  vasculitis,  since  therapeutic  approaches  differ.The  clinical  presentation  of  TTP/HUS  is  characterized  by  a  pentad  of  findings:  MAHA,  thrombocytopenia,  neurologic  abnormalities,  renal  dysfunction,  and  fever.Plasma  exchange  is  the  therapy  of  choice  for  TTP/HUS,  with  adjunctive  therapies  including  plasma  infusion,  corticosteroids,  splenectomy,  and/or  immunosuppressive  agents.TTP/HUS  is  a  hematologic  emergency,  and  patients  are  at  risk  of  developing  tissue  anoxia,  lactic  acidosis,  renal  failure,  or  catastrophic  central  nervous  system  injury.Plasma  exchange  may  be  complicated  by  catheter  accidents,  air  embolus,  citrate  toxicity,  and  pulmonary  edema.