Heparin induced thrombocytopenia with mechanical circulatory support devices: review of the literature and management considerations.
Whether for temporary or long term use, mechanical circulatory support (MCS) has seen increased utilization and interest over the past several years. Even though these devices innately cause thrombocytopenia, co-administration of heparin anticoagulation carries the risk for heparin-induced thrombocytopenia (HIT). This poses challenges for practitioners as very few studies provide guidance for the management of this condition, particularly in this population. This has led to a wide spectrum of treatment protocols within current practice. This review was developed to bring together available literature on the management of HIT in patients with MCS along with practical experience and clinical opinion in order to help guide the management of these patients.
Department of Pharmacy Services, TriStar Centennial Medical Center, Nashville, TN, USA. jonabain@gmail.com.|Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis, TN, USA. jonabain@gmail.com.
Jonathan
http://orcid.org/0000-0002-1310-3901
J
Bain
Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, USA.|Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA.
Alexander H
AH
Flannery
Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, USA.|Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA.
Jeremy
J
Flynn
University of California-Davis Health System, Sacramento, CA, USA.|University of California-San Francisco School of Pharmacy, San Francisco, CA, USA.|University of California-Davis School of Medicine, Sacramento, CA, USA.|Touro School of Pharmacy, Vallejo, CA, USA.
William
W
Dager
D005112:Extracorporeal Circulation; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D012307:Risk Factors; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000628:therapy*
D006493:Heparin
Direct thrombin inhibitors; ECLS; HIT; Heparin induced thrombocytopenia; MCS; Mechanical circulatory support