Role of Incidental UFH Flushes in the Frequency of HIT

There are two ways that "incidental" exposure to heparin by "flushing" of intra-vascular catheters can affect the frequency or clinical effect of HIT. First, such minor heparin exposures can trigger formation of HIT antibodies (Ling and Warkentin, 1998; Warkentin et al., 1998b). And second, in patients who have already formed potent HIT antibodies for any reason, any ongoing or recurrent heparin exposure—including small-dose exposure—could lead to recurrence or exacerbation of thrombocytopenia or thrombosis (Rice and Jackson, 1981). Indeed, several patients have been reported in whom severe HIT occurred while only small amounts of heparin were being given as flushes to maintain the patency of

TABLE 4 Frequency of HIT in Critically III Patients

Study

Population

Frequency of HIT clinical thrombocytopenia Suspected criteria n/N (%) HIT n/N (%)

Prospective studies Crowther 261 patients et al., 2005 critically ill medical and surgical patients

Verma et al.

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