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Critical Care
Published in: Critical Care 3/2008

01-06-2008 | Commentary

Heparin-induced thrombocytopenia during renal replacement therapy in the intensive care unit

Author: Andrew Davenport

Published in: Critical Care | Issue 3/2008

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Abstract

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.
Literature
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Lasocki S, Piednoir P, Ajzenberg N, Geffroy A, Benbara A, Montravers P: Anti-PF4/heparin antibodies associated with repeated hemofiltration-filter clotting: a retrospective study. Crit Care 2008, 12: R84.PubMedCentralCrossRefPubMed
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Parker RI: Measurement of heparin dependent platelet antibodies in the diagnosis of heparin induced thrombocyto-penia: fact or fiction? Crit Care Med 2007, 35: 1784-1785.CrossRefPubMed
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Davenport A: Heparin induced thrombocytopenia during renal replacement therapy. Hemodial Int 2004, 8: 295-303.CrossRefPubMed
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Davenport A: Sudden collapse during haemodialysis due to immune mediated heparin induced thrombocytopenia. Nephrol Dial Transplant 2006, 21: 1721-1724.CrossRefPubMed
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Metadata
Title
Heparin-induced thrombocytopenia during renal replacement therapy in the intensive care unit
Author
Andrew Davenport
Publication date
01-06-2008
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2008
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc6914

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