<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jccm-2019-0019_s_006_w2aab3b7b1b1b6b1aab1c18b1Aa"><h3>Introduction</h3><p>Sepsis is a life-threatening condition, and sepsis-associated thrombocytopenia (SAT) is a common consequence of the disease where platelet count falls drastically within a very short time. Multiple key factors may cause platelet over-activation, destruction and reduction in platelet production during the sepsis. Eltrombopag is a thrombopoietin receptor agonist and is the second-line drug of choice in the treatment of chronic immune thrombocytopenia (ITP).</p></sec><sec id="j_jccm-2019-0019_s_007_w2aab3b7b1b1b6b1aab1c18b2Aa"><h3>Aim of the study</h3><p>The objective of this study was to observe the therapeutic outcome of high dose eltrombopag in SAT management in critically ill patients.</p></sec><sec id="j_jccm-2019-0019_s_008_w2aab3b7b1b1b6b1aab1c18b3Aa"><h3>Material and Methods</h3><p>This 6-month-long single group, observational study was conducted on seventeen ICU patients with SAT. Eltrombopag 100 mg/day in two divided doses was given to each patient. Platelet counts were monitored. A low platelet blood count returning to 150 K/μL or above, is taken as indicative of a successful reversal of a thrombocytopenia event.</p></sec><sec id="j_jccm-2019-0019_s_009_w2aab3b7b1b1b6b1aab1c18b4Aa"><h3>Results</h3><p>The mean Apache II score of patients (n= 17) was 18.71 (p-value: >0.05). No eltrombopag-induced adverse event was observed among the patients during the study period. Thrombocytopenia events were reversed successfully in 64.71% of patients (11; n= 17) within eight days of eltrombopag therapy.</p></sec><sec id="j_jccm-2019-0019_s_010_w2aab3b7b1b1b6b1aab1c18b5Aa"><h3>Conclusions</h3><p>The therapeutic potentiality of high dose eltrombopag regime in the management of sepsis-associated thrombocytopenia was found clinically significant in over two-thirds of critically ill adult patients enrolled in the study. These data may point to a new strategy in the management of acute type of thrombocytopenia in septic patients.</p></sec></abstract>

IntroductionSepsis is a life-threatening condition, and sepsis-associated thrombocytopenia (SAT) is a common consequence of the disease where platelet count falls drastically within a very short time. Multiple key factors may cause platelet over-activation, destruction and reduction in platelet production during the sepsis. Eltrombopag is a thrombopoietin receptor agonist and is the second-line drug of choice in the treatment of chronic immune thrombocytopenia (ITP).Aim of the studyThe objective of this study was to observe the therapeutic outcome of high dose eltrombopag in SAT management in critically ill patients.Material and MethodsThis 6-month-long single group, observational study was conducted on seventeen ICU patients with SAT. Eltrombopag 100 mg/day in two divided doses was given to each patient. Platelet counts were monitored. A low platelet blood count returning to 150 K/μL or above, is taken as indicative of a successful reversal of a thrombocytopenia event.ResultsThe mean Apache II score of patients (n= 17) was 18.71 (p-value: >0.05). No eltrombopag-induced adverse event was observed among the patients during the study period. Thrombocytopenia events were reversed successfully in 64.71% of patients (11; n= 17) within eight days of eltrombopag therapy.ConclusionsThe therapeutic potentiality of high dose eltrombopag regime in the management of sepsis-associated thrombocytopenia was found clinically significant in over two-thirds of critically ill adult patients enrolled in the study. These data may point to a new strategy in the management of acute type of thrombocytopenia in septic patients.

The Use of High Dose Eltrombopag in the Management of Sepsis-Associated Thrombocytopenia in Critically Ill Patients

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

IntroductionSepsis is a life-threatening condition, and sepsis-associated thrombocytopenia (SAT) is a common consequence of the disease where platelet count...

Characteristics	Variables	P-values
Age (year)
Mean	54.62
Range (min-max)	47-65
Gender
Male	7
Female	10
Procalcitonin (<0.1 ng/mL)
Mean	18.43
Range (min-max)	0.7-75.0	0.556
Apache II Score (0-71)
Mean	18.71
Range (min-max)	10.0-28.0	0.980
Bilirubin (0.2 – 1.2 mg/dL)
Mean	1.43	0.516
Range (min-max)	0.6-2.3
Initial Platelet count (150-400 K/μL)
Mean	31.71	0.980
Range (min-max)	20.0-47.0

	Patient (n= 17) wise platelet count
Day	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6	Patient 7	Patient 8	Patient 9	Patient 10	Patient 11
Day 1	24	30	21	37	26	34	39	30	47	20	24
Day 2	39	41	32	53	30	69	69	45	65	23	36
Day 3	68	70	58	51	65	96	121	61	76	35	69
Day 4	84	86	89	76	86	121	133	130	51	91	92
Day 5	102	109	116	92	129	144	169	127	98	112	106
Day 6	119	127	123	136	151	152	186	142	103	139	133
Day 7	136	162	147	142	155	178	216	159	142	158	164
Day 8	154	186	165	155	162	155	244	166	165	162	161

The Use of High Dose Eltrombopag in the Management of Sepsis-Associated Thrombocytopenia in Critically Ill Patients

Article Category: Research Article

Publié en ligne: 27 nov. 2019

Pages: 123 - 129

Reçu: 15 mai 2019

Accepté: 05 août 2019

DOI: https://doi.org/10.2478/jccm-2019-0019

Mots clés
Eltrombopag, sepsis, thrombocytopenia, megakaryocytes, thrombopoietin receptor

© 2019 Md. Jahidul Hasan, Raihan Rabbani, Shihan Mahmud Redwanul Huq, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Fig. 1

Demographic and pathological information

Day and patient wise effect of eltrombopag on platelet count

The Use of High Dose Eltrombopag in the Management of Sepsis-Associated Thrombocytopenia in Critically Ill Patients

Article Category: Research Article

Publié en ligne: 27 nov. 2019

Pages: 123 - 129

Reçu: 15 mai 2019

Accepté: 05 août 2019

DOI: https://doi.org/10.2478/jccm-2019-0019

Mots clésEltrombopag, sepsis, thrombocytopenia, megakaryocytes, thrombopoietin receptor

© 2019 Md. Jahidul Hasan, Raihan Rabbani, Shihan Mahmud Redwanul Huq, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Fig. 1

Demographic and pathological information

Day and patient wise effect of eltrombopag on platelet count

Mots clés
Eltrombopag, sepsis, thrombocytopenia, megakaryocytes, thrombopoietin receptor