TLC DLC- LEUKOCYTOSIS LEUKOPENIA LYMPHOCYTOSIS EOSINOPHILIA - ICU BASICS ;DR TAPESH BANSAL🩺📽🎫

food for thought🤠🙋‍♂️🙋‍♀️
Why is there leucopenia in extracorporeal circuits ?

ANS🤷‍♂️✔

Continuous Exposure: Unlike intermittent HD, CRRT and ECMO involve continuous blood contact with the dialysis membrane for extended periods, which can lead to prolonged inflammatory responses and leukocyte activation. In HD fall in TLC is transient

Ongoing Complement Activation: The continuous flow of blood through the CRRT circuit can lead to sustained complement activation, resulting in persistent leukocyte sequestration and consumption.




Quick recap
t bansal discussed the interpretation of total and differential leukocyte counts, emphasizing the importance of identifying lymphocytosis, neutrophilia, and neutropenia. The significance of various blood cell counts and differentials in patients was also highlighted, with a focus on the need to consider other possible diagnoses beyond infection when TLC is elevated. Lastly, the doctor underscored the importance of understanding the causes and conditions related to TLC, neutrophil count, and eosinophil count, and the significance of identifying toxic granulations in a peripheral smear.

Interpreting Leukocyte Counts and Differentials
Dr. discusses interpreting total and differential leukocyte counts, focusing on recognizing lymphocytosis, neutrophilia, and neutropenia. He emphasizes examining the differential count to identify lymphocytosis, which often indicates viral illness, leukemia, or drug reaction. He explains how to calculate the absolute lymphocyte count to diagnose lymphocytosis. He also defines granulocytes, including neutrophils, eosinophils, and basophils, and immature neutrophils called bands.
Blood Cell Counts and Differentials Discussion
The doctor discussed the significance of various blood cell counts and differentials in patients. They explained that an increase in immature neutrophils, or a shift to the left in the TLC, could indicate neutrophilia or even leukemia. They emphasized the importance of considering other possible diagnoses beyond sepsis when TLC is elevated, as one-third of patients with elevated TLC may not have an infectious etiology. The doctor also highlighted that steroids could cause an increase in TLC and that this effect could persist for a few days after discontinuation.
Understanding TLC, Neutrophil, and Eosinophil Counts
The doctor discussed various causes and conditions related to total white blood cell count (TLC), neutrophil count, and eosinophil count. They highlighted the importance of understanding these conditions, as one out of every three patients in the ICU has a non-infectious cause of increased TLC. The doctor also emphasized the need to differentiate between infectious and non-infectious causes of increased TLC, as dehydration is not a cause. They further discussed the significance of identifying toxic granulations in a peripheral smear to differentiate between infection and leukemia. The doctor concluded by encouraging the team to approach TLC and DLC with a more consolidated understanding to better diagnose conditions.