Dilutional thrombocytopenia is one of many types of thrombocytopenia, which describes a low platelets count. This arises in patients who receive a very large amount of blood in multiple transfusions, which is necessary when a great deal of blood loss has occurred.
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Platelets
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Platelets are present in the bloodstream and are greatly involved in forming clots, along with multiple other clotting factors. They gather at sites of blood loss to form a clot. When fewer platelets are available, clots form more slowly and bleeding issues can develop. Normal platelet count is between 150,000 to 400,000 per microliter.
Thrombocytopenia
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If platelet values drop below 100,000 per microliter, this is defined as thrombocytopenia. This value is determined by a complete blood count, which requires a simple blood draw and submission of the blood to a laboratory.
Blood transfusion
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If a patient is anemic, meaning having low levels of red blood cells, the patient may require a blood transfusion. This often is necessary when a great deal of blood loss has occurred. Packed red blood cells are given in a blood transfusion, meaning that plasma (which includes platelets) is not given, causing the red blood cell count in the patient to increase.
Result
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When multiple transfusions are rapidly given in patients requiring them, such as in a trauma where a large amount of blood has been lost, the red blood cell count increases, therefore increasing blood volume altogether. Since only packed red blood cells are given, patients are left with the platelets they already had in a greater volume of blood, leaving many (about 75 percent of patients) with dilutional thrombocytopenia, where platelet count drops below 50,000 per microliter.
Treatment
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If bleeding problems occur, platelet transfusions may be required to increase the platelet values in the blood and assist the formation of blood clots. Over time, however, platelet values should increase as well as blood values become re-established.
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