Management of the Patient with Acute or Recent HIT

Recommendation. Alternative anticoagulation should be used for heart or vascular surgery in a patient with acute or recent HIT with detectable heparin-dependent, platelet-activating antibodies. Either bivalirudin or lepirudin are appropriate alternatives for intraoperative anticoagulation, provided that appropriate, rapid-turnaround laboratory monitoring and blood product support to manage potentially severe bleeding complications are available. Another approach is to give heparin together with a potent antiplatelet agent (Grade 2C).

Management of the Patient Following Disappearance of HIT Antibodies Recommendation. In a patient with a previous history of HIT, heart or vascular surgery can be performed using heparin, provided that HIT antibodies are absent

(by sensitive assay) and heparin use is restricted to the surgical procedure itself (Grade 1C).

0 0

Post a comment