Microangiopatías trombóticas en la unidad de cuidados intensivos

The TMA disease complex requires an adequate differentiation between primary and secondary thrombocytopenia. This requires reviewing any underlying and reversible causes with the management of multisystem support in the ICU, leading to a marked improvement in patient outcomes. The current classification is determined by the aetiology and clinical association, requiring the multiple causes of TMA to be investigated and to treat the underlying causes of each. A correct differential diagnosis is essential as the pathophysiological changes, such as pregnancy, infections, medications, etc., can be confusing or, in turn, trigger a TMA. Similarly, in the presence of a thrombotic thrombocytopenic purpura due to ADAMTS 13 protein deficiency, the starting of plasmapheresis is fundamental. Also, in view of the clinical diagnosis of atypical haemolytic uremic syndrome, the prescribing of eculizumab is a priority and definitive, since early treatment is key to changing the prognosis and improving the morbidity and mortality reported in the studies.