title: Heparin-induced thrombocytopenia in the pediatric intensive care unit population.
abstract: 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.
authors.affiliation: Department of Anesthesiology, University of Missouri, Columbia, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Frost
authors.forename: Leila
authors.initials: L
authors.lastname: Mureebe
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Russo
authors.forename: Joanne
authors.initials: J
authors.lastname: Russo
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents; D006493:Heparin