Heparin-induced thrombocytopenia in the pediatric intensive care unit population.
OBJECTIVE
To report the occurrence of heparin-induced thrombocytopenia (HIT), discuss its pathophysiology, and outline an approach to management in the pediatric intensive care unit (ICU) patient.


METHODS
Retrospective case reports.


METHODS
Pediatric ICU in a tertiary-care center.


RESULTS
Two pediatric ICU patients (2 and 6 mos of age) who developed HIT in the pediatric ICU. One was receiving heparin as a flush solution through a central line and the other had full heparinization during cardiopulmonary bypass. Both had received heparin during their neonatal course and developed thrombocytopenia; however, HIT was not considered as a possible diagnosis. HIT was diagnosed using a heparin-induced platelet aggregation study. The thrombocytopenia resolved with the cessation of heparin administration. One of the patients developed a deep vein thrombosis around a femoral venous catheter.


CONCLUSIONS
Although well described in the adult literature, there have been a limited number of reports of HIT in pediatric-aged patients. Given its potential for morbidity, HIT should be considered in the differential diagnosis of thrombocytopenia in the pediatric ICU patient.
Frost
Jason
J
Department of Anesthesiology, University of Missouri, Columbia, USA.
Mureebe
Leila
L
Russo
Pierantonio
P
Russo
Joanne
J
Tobias
Joseph D
JD
D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D012189:Retrospective Studies; D013577:Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis
D005343:Fibrinolytic Agents; D006493:Heparin