Intensive Care Med (2018) 44:893–896 https://doi.org/10.1007/s00134-018-5243-4 WHAT ’S NE W IN INTENSIVE C ARE Does this patient with thrombotic thrombocytopenic purpura have a cardiac involvement? 1 2,3 1* Lara Zafrani , Lene Russell and Elie Azoulay © 2018 Springer-Verlag GmbH Germany, part of Springer Nature and ESICM a slight increase in cardiac function, allowing VA-ECMO Clinical vignette to be discontinued. On day 6, the platelet count rose A 53-year-old man was admitted to the intensive care above 150 × 10 /l. Clinically; he was neurologically intact, unit (ICU) for thrombotic microangiopathy (TMA). His but had delirium. On day 7, heart failure recovered ad past medical history included hypercholesterolemia and integrum. He was extubated at day 11. smoking. In addition to profound thrombocytopenia (7 × 10 /l) and mechanical haemolytic anemia (positive Cardiac involvement and risk of early death schistocytes on the blood smear and negative direct anti- during TTP globulin test), he exhibited diffuse purpura on his lower TMA syndromes are defined by the association of extremities. There was neither chest pain nor clinical thrombocytopenia, microangiopathic hemolytic ane- features of congestive heart failure, and the electrocar- mia and absence of diffuse intravascular coagulation. diogram (ECG) was normal. However, cardiac
Intensive Care Medicine – Springer Journals
Published: Jun 4, 2018
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