armada81
Forum Junior
Topics: 3
Posts: 45
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hi guys ......
i would like to ask if you got a case of heparin induced thrombocytopenia within 4 days of initiating therapy and the patient is asymptomatic , platelet 90,000 / dl
PT 17 , PTT 60
what is the best next step ?
a- stop heparin and start warfarin
b- stop heparin
c- stop heparin and give platelet transfusion
d- continue heparin and observe the patient
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| studyin4ck
Forum Elite
Topics: 45
Posts: 148
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ya stop heparin...dont give warfarin...we dont give ne kind of anticoagulant...unless its a Dirtect Thromin inhibitor.
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| ibethatsurgeon
Forum Newbie
Topics: 3
Posts: 29
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Strictly speaking, HIT 1 is a benign condition that should normalize with continued heparin therapy, so no intervention is needed. However, it's HIT 2 that is immune-mediated and therefore thrombogenic, so stop heparin and begin therapy with a DTI. I believe the differential in time frames is within 2 days for HIT 1 and after 4 days for HIT 2.
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| armada81
Forum Junior
Topics: 3
Posts: 45
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ok guys i thought and answered as u said , but kaplan says that type 1 is benign and self limited and u can continue and observe only as its self limited and plt count will rise again .... i dont know how to answer this in real exam
beside that in type 2 hit we immediately stop heparin and start direct thrombin inhibitor
so if we treat both the same , why we would say type 1 and type 2 ????
i know type 1 is non immune and type 2 is immune mediated but the end result will be the same ??? does this make any sense
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| armada81
Forum Junior
Topics: 3
Posts: 45
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thank u fred33
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| icarus
Forum Guru
Topics: 56
Posts: 810
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Thanks fred.
can you guys give us your verdict on how to deal with HIT now?
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