Heparin-Induced Thrombocytopenia A Comprehensive Clinical Review

被引:134
作者
Salter, Benjamin S. [1 ]
Weiner, Menachem M. [1 ]
Trinh, Muoi A. [1 ]
Heller, Joshua [1 ]
Evans, Adam S. [1 ]
Adams, David H. [2 ]
Fischer, Gregory W. [1 ]
机构
[1] Mt Sinai Med Ctr, Dept Anesthesiol, New York, NY 10029 USA
[2] Mt Sinai Med Ctr, Dept Cardiac Surg, New York, NY 10029 USA
关键词
anticoagulant agents; antithrombin agents; argatroban; bivalirudin; cardiopulmonary bypass; platelets; MOLECULAR-WEIGHT HEPARIN; CORONARY-ARTERY-BYPASS; MICROPARTICLE GENERATION ASSAY; FACTOR 4/HEPARIN ANTIBODIES; DIRECT THROMBIN INHIBITORS; OPEN-HEART-SURGERY; CARDIOPULMONARY BYPASS; OPTICAL-DENSITY; PLASMA-EXCHANGE; CARDIAC-SURGERY;
D O I
10.1016/j.jacc.2016.02.073
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heparin-induced thrombocytopenia is a profoundly dangerous, potentially lethal, immunologically mediated adverse drug reaction to unfractionated heparin or, less commonly, to low-molecular weight heparin. In this comprehensive review, the authors highlight heparin-induced thrombocytopenia's risk factors, clinical presentation, pathophysiology, diagnostic principles, and treatment. The authors place special emphasis on the management of patients requiring procedures using cardiopulmonary bypass or interventions in the catheterization laboratory. Clinical vigilance of this disease process is important to ensure its recognition, diagnosis, and treatment. Misdiagnosis of the syndrome, as well as misunderstanding of the disease process, continues to contribute to its morbidity and mortality. (C) 2016 by the American College of Cardiology Foundation.
引用
收藏
页码:2519 / 2532
页数:14
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