Full Blood Count
ALTERNATE NAMES:
- FBC – full blood count; FBE – full blood examination; FBP – full blood picture
- CBC – complete blood count; CBE – complete blood examination; CBP – complete blood picture
RED BLOOD CELLS:
ANAEMIA
- Decreased production – nutritional deficiencies/malabsorption, marrow failure, low level of hormones (EPO, thyroid hormones)
- Increased production – haemolytic anaemia (congenital/acquired)
- Bleeding
- Haemodilution
MCV = mean cell volume
Anaemia with low MCV – microcytosis
- Fe deficiency
- thalassaemia
- sideroblastic anaemia
Anaemia with high MCV – macrocytosis
- folate or B12 deficiency
- alcohol abuse
- chronic liver disease
- hypothyroidism
- reticulocytosis
- myelodysplasia
Anaemia with normal MCV
- chronic disease
- chronic renal failure
- pregnancy
- haemolysis
- bone marrow failure
- mixed haematinic deficiency (Fe, B12)
Macrocytosis
- alcohol
- B12 deficiency
- folate deficiency
- myelodysplastic syndrome
- therapy with cytotoxics or immunosuppressants
- hypothyroidism
POLYCYTHAEMIA (Hb > 160g/L)
Relative (reduced plasma volume)
- burns
- severe dehydration
Absolute
- polycythaemia ruba vera
- myeloproliferative disorders
- chronic hypoxia (OSA, Eisenmenger)
RETICULOCYTOSIS
- acute blood loss
- any cause of premature RBC destruction
WHITE BLOOD CELLS:
NEUTROPHILIA
- stress
- sepsis
- leukemoid reactions
- corticosteroids
- malignancy
- vasculitis
NEUTROPAENIA
- infection
- cytotoxic agents
- idiosyncratic drug reactions (clozapine, carbimazole, sulphonamides, beta-lactams)
LYMPHOPAENIA
- simple stress response
- prior corticosteroid therapy
- autoimmune disease (SLE)
- infection: viral, severe sepsis, Tb, brucelliosis, histoplasmosis, HIV, CVM
- cytotoxic drugs
- radiation
LYMPHOCYTOSIS
- infection: viral, Tb, toxoplasmosis, syphilis
- thyrotoxicosis
- leukaemia
- lymphoma
ATYPICAL LYMPHOCYTES
- viral infections: EBV, CMV, HIV
- toxoplasmosis
- leukaemia
- lymphoma
- lead poisoning
- drug hypersensitivity
MONOCYTOSIS
- Tb
- leukaemia
- lymphoma
- myelodysplasia
- IBD
- convalescence from any infection
EOSINOPHILIA
- allergy
- Addisons
- parasitic infections
- sarcoidosis
- polyarteritis nodosa
- leukaemia
- lymphoma
- melanoma
- irradiation
- convalescence from any infection
BASOPHILIA
- infection: viral, Tb
- hypothyroidism
- IBD
- polysplenectomy
- leukaemia
- systemic mastocytosis
- haemolysis
- polycythaemia ruba vera
PANCYTOPAENIA
Reduced Marrow Production
- replacement of marrow (malignant cells)
- idiosyncratic Drug Reaction (chloramphenicol, sulphonamides, phenytoin, carbamazepine, gold)
- megaloblastic haematopoiesis (B12 deficiency)
- autoantibodies (SLE)
- myelofibrosis
- myelodysplasia
- toxins (benzene)
- cytotoxic agents
- overwhelming infections
Increased Peripheral Cellular Destruction
- SLE
- HIV infection
- hypersplenism
- paroxysmal nocturnal haemoglobinuria
THROMBOCYTOPAENIA
Pseudothrombocytopaenia
- -> film
- -> blue tube
Decreased Production
- bone marrow failure
- pernicious anaemia
Increased Destruction
- sepsis
- immune (ITP, TTP, HUS, HITTS)
- intravascular device (IABP, ECMO, PAC, bypass)
- drug induced (antibiotics, thiazides, H2 antagonists)
- antiphospholipid syndrome
- DIC
- HELLP
- haemolysis
Dilution
- post resuscitation
- massive transfusion
References and Links
Introduction to ICU Series
Introduction to ICU Series Landing Page
DAY TO DAY ICU: FASTHUG, ICU Ward Round, Clinical Examination, Communication in a Crisis, Documenting the ward round in ICU, Human Factors
AIRWAY: Bag Valve Mask Ventilation, Oropharyngeal Airway, Nasopharyngeal Airway, Endotracheal Tube (ETT), Tracheostomy Tubes
BREATHING: Positive End Expiratory Pressure (PEEP), High Flow Nasal Prongs (HFNP), Intubation and Mechanical Ventilation, Mechanical Ventilation Overview, Non-invasive Ventilation (NIV)
CIRCULATION: Arrhythmias, Atrial Fibrillation, ICU after Cardiac Surgery, Pacing Modes, ECMO, Shock
CNS: Brain Death, Delirium in the ICU, Examination of the Unconscious Patient, External-ventricular Drain (EVD), Sedation in the ICU
GASTROINTESTINAL: Enteral Nutrition vs Parenteral Nutrition, Intolerance to EN, Prokinetics, Stress Ulcer Prophylaxis (SUP), Ileus
GENITOURINARY: Acute Kidney Injury (AKI), CRRT Indications
HAEMATOLOGICAL: Anaemia, Blood Products, Massive Transfusion Protocol (MTP)
INFECTIOUS DISEASE: Antimicrobial Stewardship, Antimicrobial Quick Reference, Central Line Associated Bacterial Infection (CLABSI), Handwashing in ICU, Neutropenic Sepsis, Nosocomial Infections, Sepsis Overview
SPECIAL GROUPS IN ICU: Early Management of the Critically Ill Child, Paediatric Formulas, Paediatric Vital Signs, Pregnancy and ICU, Obesity, Elderly
FLUIDS AND ELECTROLYTES: Albumin vs 0.9% Saline, Assessing Fluid Status, Electrolyte Abnormalities, Hypertonic Saline
PHARMACOLOGY: Drug Infusion Doses, Summary of Vasopressors, Prokinetics, Steroid Conversion, GI Drug Absorption in Critical Illness
PROCEDURES: Arterial line, CVC, Intercostal Catheter (ICC), Intraosseous Needle, Underwater seal drain, Naso- and Orogastric Tubes (NGT/OGT), Rapid Infusion Catheter (RIC)
INVESTIGATIONS: ABG Interpretation, Echo in ICU, CXR in ICU, Routine daily CXR, FBC, TEG/ROTEM, US in Critical Care
ICU MONITORING: NIBP vs Arterial line, Arterial Line Pressure Transduction, Cardiac Output, Central Venous Pressure (CVP), CO2 / Capnography, Pulmonary Artery Catheter (PAC / Swan-Ganz), Pulse Oximeter
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC