Hematological emergencies in intensive care unit: Recognition, management protocols, and multidisciplinary care

Hematological emergencies constitute critical medical conditions that demand immediate recognition and intervention in intensive care settings. These life-threatening disorders encompass bleeding emergencies such as disseminated intravascular coagulation and trauma-induced coagulopathy, thrombotic complications including thrombotic thrombocytopenic purpura and atypical hemolytic uremic syndrome, hemolytic crises, sickle cell-related emergencies, inflammatory conditions like hemophagocytic lymphohistiocytosis, and malignancy-associated complications. The heterogeneous nature of these conditions, combined with their rapid progression potential, necessitates systematic diagnostic approaches and evidence-based management protocols. Successful outcomes depend on early identification through clinical vigilance and appropriate laboratory investigations, prompt initiation of targeted therapies, and seamless coordination among multidisciplinary care teams including intensivists, hematologists, transfusion medicine specialists, and consulting services. The complexity of managing critically ill patients with hematological emergencies requires specialized knowledge, standardized treatment protocols, and continuous quality improvement initiatives. This comprehensive review synthesizes current evidence-based approaches to recognition, diagnosis, and management of the most prevalent hematological emergencies encountered in intensive care units, emphasizing the critical importance of timely intervention and collaborative care in reducing mortality and improving patient outcomes.