Anemia   Definition  Definition of anemia, according to World Health Organization criteria  Adult men : Blood hemoglobin concentration < 13 g/dL or Hematocrit < 39%  Adult women : Blood hemoglobin concentration < 12 g/dL or Hematocrit < 37%  Mechanism  Marrow production defects: Hypoproliferation  Reflects absolute or relative marrow failure

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Thrombocytopenia    Mechanism  Decreased bone marrow production  Marrow aplasia  Fibrosis  Infiltration with malignant cells  Cytotoxic drugs  Impair megakaryocyte proliferation and maturation  Sepsis- Viral and bacterial infections  Alcohol  B12/Folate deficiency  Increased splenic sequestration : Enlargement of spleen causes fraction of sequestered platelets to

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Coagulopathy   Overview of hemostasis: Hemostasis is the process of blood clot formation at the site of vessel injury. It can be viewed as occurring in four phases: Initiation and formation of the platelet plug Propagation of the clotting process

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ANTICOAGULATION IN ICU    Clotting cascade:      Warfarin:  For patients sufficiently healthy to be treated as outpatients, we suggest initiating VKA therapy with warfarin 10 mg daily for the first 2 days followed by dosing based on INR measurements

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Disseminated Intravascular Coagulation  DIC, also called consumption coagulopathy, is a systemic process producing both thrombosis and hemorrhage. It consists of the following components:    Exposure of blood to procoagulants such as tissue factor and cancer procoagulant   Formation of fibrin within the circulation   Fibrinolysis  

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