Heparin-induced thrombocytopenia during renal replacement therapy in the intensive care unit
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Correspondence: Andrew Davenport Andrew.Davenport@royalfree.nhs.uk
Royal Free and University College Medical School, UCL Centre for Nephrology, Hampstead Campus, Rowland Hill Street, London NW3 2PF, UK
Critical Care 2008, 12:158 doi:10.1186/cc6914
Published: 30 June 2008Abstract
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.