A patient presented with ITP and a platelet count of 50,000. Splenectomy was planned. What is the best time for the anesthetist to give platelets to this patient?
|A||A day before the surgery|
|B||At the time of incision|
|C||Just after ligating the splenic artery|
|D||After removal of the spleen|
a. Idiopathic thrombocytopenic purpura (ITP) is the condition of having a low platelet count (thrombocytopeniA. of no known cause (idiopathic.
b. As most causes appear to be related to antibodies against platelets, ITP is also known as immune thrombocytopenic purpura or immune-mediated thrombocytopenic purpura.
c. A platelet count below 20,000 is generally an indication for treatment.
d. Patients with a count between 20,000 and 50,000 are usually evaluated on a case-by-case basis, and, with rare exceptions, there is usually no need to treat patients with a count above 50,000
e. A count below 10,000 is potentially a medical emergency, as the patient may be vulnerable to subarachnoid or intracerebral hemorrhage as a result of moderate head trauma.
a. Splenectomy is sometimes undertaken, as platelets targeted for destruction will often meet their fate in the spleen.
b. The procedure is potentially risky in ITP cases due to the increased possibility of significant bleeding during surgery.