Risk Factors of Hospital-acquired Thrombocytopenia in Toxicological Intensive Care Unit: Thrombocytopenia in Toxicological Intensive Care Unit

Background: Platelet count is a readily available biomarker predicting disease severity and risk of mortality in the intensive care units (ICU). This study aims to describe the frequency, to assess the risk factors, and to evaluate the impact of thrombocytopenia on patient outcomes in a Toxicological ICU (TICU).Methods: In this prospective observational Cohort study, we enrolled 184 patients admitted to our TICU from October 1st, 2019, to August 23rd, 2020. Mild/moderate and severe thrombocytopenia were defined as at least one platelet counts less than 150×103/µL and 50×103/µL during the ICU stay, respectively.Results: Of 184 enrolled patients, 45.7% had mild to moderate thrombocytopenia and 5.4% had severe thrombocytopenia. Old age (OR: 1.042, 95%CI: 1.01-1.075, P=0.01), male gender (OR: 4.348, 95%CI: 1.33-14.22, P=0.015), increased international normalized ratio (INR) levels (OR: 3.72, 95%CI: 1.15-112, P=0.028), and administration of some medications including heparin (OR: 3.553, 95%CI: 1.11-11.36, P=0.033), antihypertensive drugs (OR: 2.841, 95%CI: 1.081-7.471, P=0.034), linezolid (OR: 13.46, 95%CI: 4.75-38.13, P<0.001), erythromycin (OR: 19.58, 95%CI: 3.23-118.86, P=0.001), and colistin (OR: 10.29, 95% CI 1.44-73.69, P=0.02) were the risk factors of hospital-acquired thrombocytopenia. The outcomes of patients with normal platelet count were significantly better than those who developed thrombocytopenia (P<0.001).Conclusion: We found that thrombocytopenia could develop in almost 50% of patients admitted to TICU, which is associated with poor prognosis. Additionally, the platelet counts should be closely monitored to administer some medications (heparin, antihypertensive drug, and linezolid), especially in old patients

A Survey of the Protective Effect of Vitamin B6 on Linezolid-Associated Hematological Dyscrasia: Vitamin B6 and linezolid hematological toxicities

Hematological toxicities are considerable side effects of linezolid, which can restrict its administration. This study aims to evaluate the protective effect of vitamin B6 on linezolid-induced hematological dyscrasia, i.e., thrombocytopenia and anemia in poisoned patients. In this quasi-experimental (non-randomized, non-blinded) study, a number of 28 patients treated with linezolid and vitamin B6 were matched with 50 patients who received only linezolid. The hematological factors, including red blood cells (RBCs), hemoglobin (Hb), hematocrit (Hct), and platelets (PLTs) were assessed at baseline and on days 0, 1, 3, 5, and 7 during the linezolid treatment coarse. There were no considerable differences between the two groups in demographic characteristics, poisoning, vital signs, baseline laboratory test results, and mortality rates. Overall, patients who received linezolid+B6 had significantly higher RBCs, Hb, and Hct than those treated with linezolid alone (P < 0.05). Unexpectedly, patients in the treatment group had lower PLT counts compared to the control group with no significant differences (P > 0.05). According to our findings, the co-administration of vitamin B6 and linezolid was accompanied by a lower risk of anemia but no impact on preventing or reducing thrombocytopenia in patients with gram-positive bacterial infections