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Hear this out loud PauseLumbar punctures (LP) are routinely used to administer intrathecal chemotherapy for children and adults with hematologic malignancies. The current guidelines suggest a platelet threshold of 50 109/L prior to LP for intrathecal chemotherapy (ITC).
Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma.
Platelets are tiny cells in the blood that form clots to help stop bleeding. If a person with a low platelet counts requires surgery they are at increased risk of bleeding during and after surgery.
Prophylactic Transfusion Threshold To prevent spontaneous bleeding - transfuse at less than 10,000 cells/microliter; some recommend less than 5,000 cells/microliter. Before neurosurgery or ocular surgery - less than 100,000 cells/microliter. Before major surgery - less than 50,000 cells/microliter.
Platelets are found in the blood and are an essential part of a blood clot. A low platelet count increases the risk of bleeding. People with a low platelet count often require a lumbar puncture or epidural anaesthetic for administration of treatment or to aid in diagnosis.
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Hear this out loud PausePlatelets are found in the blood and are an essential part of a blood clot. A low platelet count increases the risk of bleeding. People with a low platelet count often require a lumbar puncture or epidural anaesthetic for administration of treatment or to aid in diagnosis.
Hear this out loud PausePlatelet transfusion is indicated for patients with congenital or acquired functional platelet defectsincluding complex cardiac surgery or patients on antiplatelet therapy (other than aspirin alone) requiring surgical interventionwho are actively bleeding. Platelet counts are not a reliable indicator in this case.
In the absence of these additional risk factors, a platelet count of 80 x 10(9)/l is a safe count for placing an epidural or spinal anaesthetic and 40 x 10(9)/l is a safe count for lumbar puncture.

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