Haematology in Critical Care

Dr Jecko Thachil, Honorary Consultant in Haemostasis and Thrombosis, Royal Liverpool Teaching Hospitals, Academic Clinical Lecturer, Infection and Global Health, University of Liverpool, Liverpool, UK Dr Thachil co-chairs the Disseminated Intravascular Coagulation Subcommittee of the International Society of Thrombosis and Haemostasis and is the review editor for Physician Information and Educational Resource for American College of Physicians. He has authored over seventy publications in peer reviewed journals and has co-authored the British committee of Standards in Haematology guideline for DIC. Dr Thachil also has research collaborations with intensive care staff in the northwest England and is the organizer of Haematology in Intensive Care educational sessions for the region. Dr Quentin A. Hill, Consultant Haematologist, Leeds Teaching Hospital NHS Trust, Honorary Senior Lecturer, University of Leeds, Leeds, UK Dr Hill has been principle investigator for a number of phase II and III clinical trials and has published 6 peer reviewed journal articles (5 as first author). He has also written book chapters for "Problem Solving in Haematology" published in March 2010 (ISBN: 1846920051, Atlas Medical Publishing, Ltd). He provides attending cover for a 40 bedded haematology unit.  He often interacts with intensive care staff and has developed an interest in critical care issues during this time. Dr Hill has published a single author review on survival of critically ill patients with haematological malignancy in 2010 and has submitted a further paper on regional ICU outcomes for publication. Dr Hill has lectured on this subject regionally and nationally.

List of Contributors, v

Preface, ix

Acknowledgements, x

Section 1 Approach to Abnormal Blood Tests

1 Diagnostic Approach to Anaemia in Critical Care, 3
Stephen F. Hawkins and Quentin A. Hill

2 Leukopenia, 9
Stephen F. Hawkins, Jecko Thachil and Quentin A. Hill

3 Thrombocytopenia in the Intensive Care Unit, 12
Jecko Thachil

4 High Blood Counts, 16
Quentin A. Hill

5 The Abnormal Clotting Profile, 26
Jecko Thachil

6 Understanding the Blood Film, 31
Stephen F. Hawkins and Quentin A. Hill

Section 2 Approach to Coagulation Problems

7 Venous Thromboembolism in Intensive Care, 39
Sarah A. Bennett and Roopen Arya

8 Reversal and Monitoring of Anticoagulants, 45
Joost J. van Veen

9 Disseminated Intravascular Coagulation, 52
Jecko Thachil

10 Heparin-Induced Thrombocytopenia, 58
Jerrold H. Levy and Anne M. Winkler

11 Thrombotic Microangiopathies, 62
Mari Thomas and Marie Scully

12 Critical Care of Patients with a Congenital Bleeding Disorder, 69
Vanessa Martlew

Section 3 Approach to Transfusion Problems

13 Blood Components and Their Contents, 77
Shubha Allard

14 Transfusion Reactions, 86
Therese A. Callaghan

15 The Management of Non-traumatic Massive Haemorrhage, 93
Nicola S. Curry and Simon J. Stanworth

16 Plasma Exchange, 100
Khaled El-Ghariani

Section 4 Approach to Red Cell Problems

17 Appropriate Haemoglobin in Intensive Care, 107
Jonathan Wallis and Stephen Wright

18 Sickle Cell Disease and Thalassaemia in the Critical Care Setting, 112
Andrew Retter and Jo Howard

19 Management of Patients Who Refuse Blood Transfusion, 118
Derek R. Norfolk and Fran Hartley

Section 5 Approach to White Cell Problems

20 Infectious Complications in the Immunosuppressed Patient, 125
Tim Collyns and Elankumaran Paramasivam

21 Haematopoietic Stem Cell Transplantation (HSCT), 135
John Snowden and Stephen Webber

22 Multiple Myeloma and Hyperviscosity Syndrome, 144
Amin Rahemtulla and Joydeep Chakrabartty,

23 Palliative Care for the Patient with Haematological Malignancy in Intensive Care, 148
Suzanne Kite

Section 6 Admission to Intensive Care

24 Haematological Malignancy Outside Intensive Care: Current Practice and Outcomes, 159
Charlotte Kallmeyer

25 Early Care of the Unstable Patient: Preventing Admission to the Intensive Care Unit, 165
Andrew Breen

26 Decisions to Intensify Treatment: Who Will Benefit from Intensive Care?, 171
Quentin A. Hill and Peter A. Hampshire

Section 7 Point-of-Care Testing

27 The Relevance of Thromboelastography in Intensive Care Patients, 179
Jon Bailey and Nicola S. Curry

Section 8 Haematology Drugs in Critical Care

28 Recombinant Activated Coagulation Factor VII (rFVIIa) in Critical Care, 187
Leon Cloherty and Richard Wenstone

29 The Use of Haemostatic Drugs in Post-operative Bleeding, 192
Catharina Hartman and Nigel Webster

30 Delivering Chemotherapy on Intensive Care, 196
Arvind Arumainathan and Daniel Collins

Section 9 Haematology in Paediatric and Neonatal Intensive Care

31 Neonatal Anaemia, 207
Michael Richards

32 Haemolysis, 213
Michael Richards

33 Approach to Thrombocytopenia, 219
Amrana Qureshi

34 Blood Component Therapy in Children and Neonates, 224
Anne Kelly, Simon J. Stanworth and Helen V. New

Section 10 Haematological Emergencies

35 Haematological Emergencies, 235
Quentin A. Hill and Amin Rahemtulla

Appendix A: Adult, Paediatric and Neonatal Haematology Reference Intervals, 243
Quentin A. Hill

Index, 249