Update on the Treatment of Heparin-Induced Thrombocytopenia

Required reading for all learners: Implicit Bias impacts patient outcomes

The use of unfractionated heparin and low-molecular-weight heparin remains widespread for the treatment and prevention of various thromboembolic disorders. Benefits of unfractionated heparin include its quick onset of action, short half-life, ease of monitoring, and reversibility. Low-molecular-weight heparin has the additional advantages of more predictable anticoagulant activity, less frequent monitoring, and potential use in the ambulatory setting. Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening complication of heparin exposure associated with potential thrombosis, limb gangrene and amputation, and death. The incidence of HIT ranges from less than 0.1% to 5% of patients and varies according to patient factors. The risk is highest in patients receiving unfractionated heparin (as opposed to low molecular weight heparin), those undergoing cardiac surgery, and those receiving therapeutic doses.