Q: Intra-Aortic-Balloon-Pump (IABP) associated thrombocytopenia is usually benign. It is common to have intravenous infusion of Heparin along with IABP. Studies have shown very safe profile even if both modalities of treatments are applied together. But, at what point Heparin Induced Thrombocytopenia (HIT) should become a concern?


Answer: HIT occurs in about 3% of patients who receive both IABP and heparin simultaneously. IABP-associated thrombocytopenia usually stabilized after 72-96 hours of counterpulsation. But if it does not stabilizes or continue to fall after that time-period, HIT should be considered due to its lethal implications.




Reference: 

Bream-Rouwenhorst HR1, Hobbs RA, Horwitz PA.J - Thrombocytopenia in patients treated with heparin, combination antiplatelet therapy, and intra-aortic balloon pump counterpulsation. - .J Interv Cardiol. 2008 Aug;21(4):350-6.