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Thresholds for Platelet Transfusion in a Patient with Idiopathic Thrombocytopenic Purpura About to Undergo an Invasive Procedure

Description

A patient with idiopathic thrombocytopenic purpura (ITP) may not bleed despite a very low platelet count provided that they do not suffer trauma. Most surgeons want the platelet count to be above a certain level before they operate on these patients.


Platelet Count

Procedure

>= 10,000 per µL

minor dental procedure

>= 30,000 per µL

dental extraction; regional oral nerve block

>= 50,000 per µL

minor surgery, vaginal delivery

>= 80,000 per µL

major surgery, Cesarian section, epidural anesthesia, spinal block

>= 100,000 per µL

craniotomy

 

The platelet count given is the number functional platelets. If the patient has an acquired platelet defect then a higher platelet count will be required.

 

Platelets alone will not control all hemorrhage. Surgical technique, underlying disease, concurrent medications and coagulation factors all contribute to hemostasis.

 


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