Heparin-induced thrombocytopenia in the pediatric intensive care unit population.

Abstract

OBJECTIVES:

To report the occurrence of heparin-induced thrombocytopenia (HIT), discuss its pathophysiology, and outline an approach to management in the pediatric intensive care unit (ICU) patient.

DESIGN:

Retrospective case reports.

SETTING:

Pediatric ICU in a tertiary-care center.

PATIENTS AND RESULTS:

Two pediatric ICU patients (2 and 6 mos of age) who developed HIT in the pediatric ICU. One was receiving heparin as a flush solution through a central line and the other had full heparinization during cardiopulmonary bypass. Both had received heparin during their neonatal course and developed thrombocytopenia; however, HIT was not considered as a possible diagnosis. HIT was diagnosed using a heparin-induced platelet aggregation study. The thrombocytopenia resolved with the cessation of heparin administration. One of the patients developed a deep vein thrombosis around a femoral venous catheter.

CONCLUSION:

Although well described in the adult literature, there have been a limited number of reports of HIT in pediatric-aged patients. Given its potential for morbidity, HIT should be considered in the differential diagnosis of thrombocytopenia in the pediatric ICU patient.

• Authors: Jason Frost, Leila Mureebe, Pierantonio Russo, Joanne Russo, Joseph D Tobias
• Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies (Pediatr Crit Care Med) Vol. 6 Issue 2 Pg. 216-9 (Mar 2005) ISSN: 1529-7535 [Print] United States
• PMID: 15730612 (Publication Type: Case Reports, Journal Article)

Chemical References

• Fibrinolytic Agents
• Heparin

Topics

• Fibrinolytic Agents (adverse effects)
• Heparin (adverse effects)
• Humans
• Infant
• Intensive Care Units, Pediatric
• Male
• Retrospective Studies
• Syndrome
• Thrombocytopenia (chemically induced, diagnosis)