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Seminars in Cardiothoracic and Vascular Anesthesia
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Heparin-Induced Thrombocytopenia

David Cummins, MD, MRCP, MRCPath

Departments of Haematology and Anaesthesia, Harefield Hospital, Harefield, Middlesex, United Kingdom

Elaine Hill, FRCA

Departments of Haematology and Anaesthesia, Harefield Hospital, Harefield, Middlesex, United Kingdom

Heparin's anticoagulation effect makes it the principal component in the immediate treatment of all thrombotic diseases. After hemorrhage, the most important complication of heparin is thrombocytopenia, the decrease in the number of blood platelets. Ten cases of "heparin-induced thrombocytopenia" are described, and guidelines for diagnosing heparin-induced thrombocytopenia in patients who present for cardiac and vascular surgery are given. Methods of treating patients with heparin-induced thrombocytopenia, including use of arachidonic acid derivatives, antiplatelet agents, other anticoagulants, heparinoids, natural and synthetic thrombin inhibitors, hirudin, and defibrinogenation with ancrod, are discussed.

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 1, No. 4, 349-365 (1997)
DOI: 10.1177/108925329700100408


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