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Research ArticleOpen Access

Enoxaparin in Suspected Heparin Induced Thrombocytopenia: An Observational Follow-Up in Critically Ill Patients

Volume 3 - Issue 3

Mohammad Taghi Beigmohammadi*1, Zahid Hussain Khan2 and HosseinKhalili3

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    • 1Department of Anesthesiology and Intensive Care, University of Medical Sciences, Iran
    • 2Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Iran
    • 3Department of Pharmacotherapy, Tehran University of Medical Sciences, Iran

    *Corresponding author: Mohammad Taghi Beigmohammadi, Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Received: March 16, 2018;   Published: April 05, 2018

DOI: 10.26717/BJSTR.2018.03.000913

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Background: HIT is overdiagnosedin ICU patients and this leads to inappropriate use of direct agents and bleeding. In this observational study safety use of enoxaparine in critically ill patients with high probable HIT has been evaluated. Materials and Methods: In observational study, out of 564 patients admitted to the ICUs during 2012-2014, 88 patients with suspected HIT based on the clinical criteria (4Ts score) received either enoxaparin (n=48) or no treatment as control group (n=40). All of the patients had normal platelet count at hospital admission developed thrombocytopenia (plt<100000/μl).The patients were followed for 5 days for any evidence of thromboemboli, bleeding, petechiae, cutaneous necrosis. Doppler ultrasound of the lower limbs was performed as indicated and the peripheral blood smear was obtained for detection of platelet aggregation. A p value less than 0.05 was considered statistically significant.

Results: Return of platelet count to the normal range value occurred more frequently in the enoxaparin than the control group. Frequency of clinical HIT based on the 4Ts score was not significantly different between the groups. Thrombosis was less in enoxaparine than the control group (4.2% vs. 15%) and in follow up Doppler ultrasound, new thrombosis was not seen in the enoxaparine group.

Conclusion: Clinical HIT 4Ts score is not a valid tool for evaluation of HIT in critically ill patients and thus HIT is usually over-diagnosed. A reliable clinical HIT scoring for critically ill patients is necessary.

Keywords: Heparin; Thrombocytopenia; Enoxaparin; Critically ill patients

Abstract| Introduction| Methods| Results| Discussion| Conclusion| References|