All right, welcome back to the Internet Book of Critic Precure Podcast. I'm here with Adam Thomas,

and we're going to talk about thromacetopinia and heparin-induced thromacetopinia.

The platelets, the platelets, the platelet count. We never look at it. We ignore it, right? We don't

have to talk about it around? I try to ignore it. It's always screwed up, but I try to ignore it. Now, one thing I'll say, if you need a breath of fresh air, come listen to this

podcast. Because as opposed to the classic production, sequestration, destruction things that

everybody goes through in med school, Josh has actually organized this in a more meaningful

and practical way when we're thinking about the platelet count in our critically ill patients.

So today, we're going to talk about the differential as it applies to the ICU when the platelet count is low.

Then we'll talk about that workup and who you actually have to look at hit as a major issue instead of just running the assay on everyone, right, Josh?

Yeah.

Let's move into it.

Let's talk about the overview and when should we actually be concerned and start sending

some labs off.

This is honestly a tough one because thermocitinia is super common in the ICU.

So it can be a little tricky to know exactly when to pull the trigger on doing a big

evaluation.

I think patients with really severe thromcytoppenia,

if there's a concern of hit, bleeding or clotting, those things definitely weren't to work up.

And the patient is thromestopinic. You don't know what's going on and you think maybe there's some

sort of underlying unifying hematologic process like TTP or HLH, then those people certainly need

to work up. But at the same time, I think it's important to realize that a lot of your septic patients are going to have just this low-grade thromacetopinia of 100, 90, 140,

and that usually kind of tracks with their illness. And as long as it's getting better,

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