Q:  52 year old male is admitted to ICU as "Pre-op" CABG patient. Previous admission record showed patient with diagnosis of HIT (Heparin Induced Thrombocytopenia) 2 years ago. You rechicked HIT test and OD (optimal density) for HIT is reported as 0.2. What would be your advise on use of Heparin?


Answer:  Patients with previous history of HIT but now with negative antibodies can have heparin during CBP but it should be avoided pre or post surgery.




References:

1. Follis F, Schmidt CA. Cardiopulmonary bypass in patients with heparin-induced thrombocytopenia and thrombosis. Ann Thorac Surg. 2000;70:2173-2181.

2. Warkentein TE. Heparin-induced thrombocytopenia: pathogenesis, frequency, avoidance and management. Drug Safety. 1997;17:325-341.