PMID- 26363901
OWN - NLM
STAT- MEDLINE
DCOM- 20160808
LR  - 20220408
IS  - 1557-8615 (Electronic)
IS  - 0883-9441 (Linking)
VI  - 30
IP  - 6
DP  - 2015 Dec
TI  - Clinically suspected heparin-induced thrombocytopenia during extracorporeal 
      membrane oxygenation.
PG  - 1190-4
LID - S0883-9441(15)00428-1 [pii]
LID - 10.1016/j.jcrc.2015.07.030 [doi]
AB  - PURPOSE: Patients receiving extracorporeal membrane oxygenation (ECMO) are at 
      risk for thrombocytopenia including heparin-induced thrombocytopenia (HIT). The 
      purpose of this study was to determine the frequency of suspected HIT in patients 
      receiving ECMO and unfractionated heparin (UFH). MATERIALS AND METHODS: We 
      conducted a retrospective review in adult patients on ECMO. Patients were 
      included if they received ECMO for at least 5 days and concomitant UFH. RESULTS: 
      There were 119 patients who met inclusion criteria. Twenty-three patients (19%) 
      had a heparin-platelet factor 4 immunoassay performed. Patients with suspected 
      HIT had a significantly lower platelet count within the first 3 days of ECMO, 
      69x10(9)/L (22-126x10(9)/L) vs 87.5x10(9)/L (63-149x10(9)/L); P=.04. The lowest 
      platelet count on the day of HIT testing was 43x10(9)/L (26-73), representing a 
      71% reduction from baseline. Twenty patients (87%) had an optical density score 
      less than 0.4, and all patients had a score less than 1.0. A functional assay was 
      performed in 7 patients (30%), with only 1 patient having laboratory-confirmed 
      HIT. CONCLUSIONS: The evaluation of HIT occurred in a small percentage of 
      patients, with HIT rarely being detected. Patients who had heparin-platelet 
      factor 4 immunoassay testing exhibited lower platelet counts with a similar 
      duration of ECMO and UFH exposure.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Glick, Daryl
AU  - Glick D
AD  - Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University 
      Medical Center, New York, NY 10032. Electronic address: dglickk@gmail.com.
FAU - Dzierba, Amy L
AU  - Dzierba AL
AD  - Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University 
      Medical Center, New York, NY 10032.
FAU - Abrams, Darryl
AU  - Abrams D
AD  - Department of Pulmonary, Allergy and Critical Care Medicine, Columbia University 
      Medical Center, New York, NY 10032.
FAU - Muir, Justin
AU  - Muir J
AD  - Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University 
      Medical Center, New York, NY 10032.
FAU - Eisenberger, Andrew
AU  - Eisenberger A
AD  - Department of Hematology, Columbia University Medical Center, New York, NY 10032.
FAU - Diuguid, David
AU  - Diuguid D
AD  - Department of Hematology, Columbia University Medical Center, New York, NY 10032.
FAU - Abel, Erik
AU  - Abel E
AD  - Department of Cardiothoracic Surgery, The Ohio State University Wexner Medical 
      Center, Columbus, OH 43210.
FAU - Agerstrand, Cara
AU  - Agerstrand C
AD  - Department of Pulmonary, Allergy and Critical Care Medicine, Columbia University 
      Medical Center, New York, NY 10032.
FAU - Bacchetta, Matthew
AU  - Bacchetta M
AD  - Department of Cardiothoracic Surgery, Columbia University Medical Center, New 
      York, NY 10032.
FAU - Brodie, Daniel
AU  - Brodie D
AD  - Department of Pulmonary, Allergy and Critical Care Medicine, Columbia University 
      Medical Center, New York, NY 10032.
LA  - eng
PT  - Journal Article
DEP - 20150801
PL  - United States
TA  - J Crit Care
JT  - Journal of critical care
JID - 8610642
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticoagulants/*adverse effects
MH  - Blood Coagulation
MH  - Critical Care
MH  - Extracorporeal Membrane Oxygenation/*adverse effects
MH  - Female
MH  - Heparin/*adverse effects/chemistry
MH  - Hospitalization
MH  - Humans
MH  - Immunoassay/methods
MH  - Intensive Care Units
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Thrombocytopenia/*chemically induced
OTO - NOTNLM
OT  - Blood
OT  - Circulatory temporary support
OT  - Coagulation/anticoagulation
OT  - Extracorporeal membrane oxygenation
OT  - Platelets
EDAT- 2015/09/14 06:00
MHDA- 2016/08/09 06:00
CRDT- 2015/09/14 06:00
PHST- 2015/06/03 00:00 [received]
PHST- 2015/07/14 00:00 [revised]
PHST- 2015/07/28 00:00 [accepted]
PHST- 2015/09/14 06:00 [entrez]
PHST- 2015/09/14 06:00 [pubmed]
PHST- 2016/08/09 06:00 [medline]
AID - S0883-9441(15)00428-1 [pii]
AID - 10.1016/j.jcrc.2015.07.030 [doi]
PST - ppublish
SO  - J Crit Care. 2015 Dec;30(6):1190-4. doi: 10.1016/j.jcrc.2015.07.030. Epub 2015 
      Aug 1.