title: Cardiac surgery and heparin induced thrombocytopaenia (HIT): a case report and short review.
abstract: This patient presented for emergency cardiac surgery following two episodes of thrombocytopaenia, one before and one associated with exposure to unfractionated heparin in a seven-week period of intensive care management. Although the diagnosis of heparin induced thrombocytopaenia (HIT) was uncertain on clinical grounds when assessed by current criteria, the positive antibody status directed management in accordance with the internationally recognised guidelines published by the American College of Chest Physicians (ACCP) Evidence-based Clinical Practice Guidelines. An alternative anticoagulant to unfractionated heparin was indicated for cardiopulmonary bypass. Bivalirudin was selected because of recent literature supporting its safe use.
authors.affiliation: Sydney Adventist Hospital, Sydney, Australia. mcmenima@bigpond.net.au
authors.forename: W J
authors.initials: WJ
authors.lastname: McMeniman
authors.forename: R B
authors.initials: RB
authors.lastname: Chard
authors.forename: J
authors.initials: J
authors.lastname: Norrie
authors.forename: J
authors.initials: J
authors.lastname: Posen
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D006493:Heparin / Q000009:adverse effects*; D006629:Hirudins / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000009:adverse effects*; D010979:Platelet Function Tests; D011994:Recombinant Proteins / Q000009:adverse effects; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin