Platelet count monitoring for heparin-induced thrombocytopenia (HIT) in patients receiving anticoagulation

Risk of HIT	Population	Platelet count monitoring^[1]
Low (<0.1%)	Medical or obstetric patients receiving LMW heparin Minor surgery or minor trauma patients receiving LMW heparin Patients receiving fondaparinux or an anticoagulant not associated with development of HIT	Suggest against monitoring
Intermediate (≥0.1 to 1%)	Medical or obstetric patients receiving UFH Major surgery or major trauma patients receiving LMW heparin	Suggest monitoring every 2 to 3 days from day 0 through day 14
High (>1%)	Major surgery or major trauma patients receiving UFH

All patients treated with anticoagulation should have a baseline platelet count prior to starting the anticoagulant. For patients receiving UFH plus another anticoagulant, use the risk for UFH. The risk of HIT is higher for therapeutic dose UFH than for lower doses (including heparin flushes). More or less frequent monitoring may be reasonable depending on the judgement of the treating clinicians. Refer to UpToDate and the 2018 ASH guidelines for details and supporting evidence.

HIT: heparin-induced thrombocytopenia; Plt: platelet; LMW: low molecular weight; UFH: unfractionated heparin.

Reference:

Cuker A, Arepally GM, Chong BH, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood Advances 2018; 2:3360.

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خرید پکیج

Platelet count monitoring for heparin-induced thrombocytopenia (HIT) in patients receiving anticoagulation