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Her delivery was further complicated by postpartum haemorrhage and she was admitted to the Intensive Care Unit (ICU) for further resuscitation and seizure control which required infusions of magnesium and multiple anticonvulsants. Despite haemodynamic optimisation she developed an acute kidney injury with evidence of liver damage, thrombocytopenia and haemolysis. Haemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome, a multisystem disease of advanced pregnancy which overlaps with pre-eclampsia, was diagnosed. HELLP syndrome is associated with a range of complications which may require critical care support, including placental abruption and foetal loss, acute kidney injury, microangiopathic haemolytic anaemia, acute liver failure and liver capsule rupture. Definitive treatment of HELLP is delivery of the fetus and in its most severe forms requires admission to the ICU for multiorgan support. Therapeutic strategies in ICU are mainly supportive and include blood pressure control, meticulous fluid balance and possibly escalation to renal replacement therapy, mechanical ventilation, neuroprotection, seizure control, and management of liver failure-related complications. Multidisciplinary input is essential for optimal treatment.<\/jats:p>","DOI":"10.1177\/17511437211025410","type":"journal-article","created":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T08:32:31Z","timestamp":1623918751000},"page":"372-378","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Haemolysis, elevated liver enzymes and low platelets: Diagnosis and management in critical care"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7803-0443","authenticated-orcid":false,"given":"Evangelia","family":"Poimenidi","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care, University Hospitals Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yavor","family":"Metodiev","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Cardiff and Vale University Health Board, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha Nicole","family":"Archer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospitals Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5039-5184","authenticated-orcid":false,"given":"Mansoor Nawaz","family":"Bangash","sequence":"additional","affiliation":[{"name":"Birmingham acute care research group, Institute of inflammation and ageing, University of Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip Alexander","family":"Howells","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Royal Brompton and Harefield NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"bibr1-17511437211025410","unstructured":"Intensive Care National Audit & Research Centre. 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