Heparin-induced thrombocytopenia during renal replacement therapy in the intensive care unit.
Whereas some 30% to 50% of patients admitted to the intensive care unit develop thrombocytopenia during their stay, the incidence of heparin-induced thrombocytopenia (HIT) remains low, at around 0.3% to 0.5%. Lasocki and colleagues prospectively tested patients with premature clotting of the hemofiltration circuit for HIT, and reported a 25% incidence of HIT, particularly if the circuit clotted within 6 hours. By switching the anticoagulant from heparin to danaparoid, the hemofiltration circuit survival and urea clearances improved. HIT should therefore be clinically suspected if extracorporeal circuits clot repeatedly.
Davenport
Andrew
A
Royal Free and University College Medical School, UCL Centre for Nephrology, Hampstead Campus, Rowland Hill Street, London NW3 2PF, UK. Andrew.Davenport@royalfree.nhs.uk
D000925:Anticoagulants / Q000009:adverse effects* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D006493:Heparin / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D007362:Intensive Care Units; D017582:Renal Replacement Therapy; D013921:Thrombocytopenia / Q000139:chemically induced*
D000925:Anticoagulants; D001323:Autoantibodies; D006493:Heparin