Dewitte A, et al. Blood platelets and sepsis pathophysiology: a new therapeutic prospect in critical ill patients?

Ann Intensive Care. 2017;115.

Multiple Causes of Thrombocytopenia in
Sepsis
• Decreased platelet production in bone marrow
• Result from pre-existing conditions / from the inhibitory effect of pathogen
toxins, drugs, or inflammatory mediators
• Reduction in platelet half-life and their consumption/destruction
(peripheral mechanism)
• Linked to many events of platelet activation in sepsis, intravascular
coagulopathy, and immune mechanisms
• Drug-induced thrombocytopenia, hemophagocytosis, bleeding, and
hemodilution

Dewitte A, et al. Blood platelets and sepsis pathophysiology: a new therapeutic prospect in critical ill patients? Ann Intensive Care. 2017;115.
Step-by-step of Thrombocytopenia in Sepsis
• 1st point of view:
• Platelet count reduction caused by consumption mechanisms of pathogen,
pathogen product-mediated activation, induction of apoptosis, lysis and
increased phagocytic clearance  leads to thrombocytopenia
• Following mechanisms:
• Coagulopathy, DIC, platelet sequestration by leukocytes and by inflammatory
vascular beds  stressed mechanisms of thrombocytopenia

Dewitte A, et al. Blood platelets and sepsis pathophysiology: a new therapeutic prospect in critical ill patients? Ann Intensive Care. 2017;115.