RT - Signa Vitae ID - 10.22514/SV121.102016.24 T1 - Massive RBC fragmentation masks severe thrombocytopenia in both impedance and optical platelet count measurements – a case report of a neonate on ECMO support A1 - ANA MLINARIĆ A1 - GORDANA FRESSL JUROŠ A1 - DUNJA ROGIĆ K1 - platelet count K1 - ECMO K1 - frag-mented RBC K1 - neonates K1 - analytical interfer-ence YR - 2016 SP - 128 AB -

Extracorporeal membranous oxygenation (ECMO) is a life-saving treatment for pae-diatric patients with cardiac or respiratory failure of diverse aetiology. ECMO sup-port is implemented only when all other available medications and procedures fail to treat the underlying cause of organ fail-ure. The reason for caution is a high risk of complications, including intravascular haemolysis, bleeding or clot formation, inflammation and sepsis. Platelet count is closely monitored in assessment of bleed-ing risk associated with ECMO support. Platelets are counted as a parameter of the complete blood count and can be measured using impedance or optical technology. We report a case of severe red blood cell (RBC) fragmentation in a neonate on ECMO in whom erroneously normal platelet counts were obtained by all available automated methods for platelet count in an emergen-cy laboratory. Based on those observations we have implemented an additional proce-dure for recognising interferences of frag-mented and microcytic RBCs that cause spuriously normal platelet counts.