%0 Journal Article
%T Low Incidence of Clinically Significant Heparin Induced Thrombocytopenia after Cardiopulmonary Bypass Surgery
%A Abhinav B Ch
%A Anuradha Belur
%A Himanshu Pathak
%A Navneet Mittal
%A Shilpa Sambidi
%A Swati Pathak
%A Yiqing Xu
%A ra
%J Open Journal of Immunology
%D 2014
%R 10.4172/2155-9864.1000180
%X Introduction: Thrombocytopenia after cardiopulmonary bypass (CPB) is common, and the diagnosis of heparin induced thrombocytopenia (HIT) remains a challenge in clinical practice despite the guidance from the Ħ°4TĦħ diagnostic scoring criteria and the laboratory tests. Objectives: This study aims to evaluate (i) the temporal laboratory characteristics of thrombocytopenia after CPB and (ii) the incidence of clinically significant HIT based on clinical assessment. Methods: A retrospective data review of patients undergoing coronary artery bypass graft surgery or valve surgery who were also placed on bypass pump and received intra-operative heparin. Results: Among 450 study patients, 142 (31.5%) patients developed decrease of platelet counts at least 33% below base line following surgery, with a median degree of 61%. The initial platelet nadir occurred between day 0 to day 4 (median 1 day). The cumulative percentage of patients demonstrating recovery of their platelet count was 44% by day 4, 80% by day 5 and 100% by day 10. Only 9 patients (2%) showed a second decrease in platelet count. By clinical assessment, including clinical outcome, platelet recovery, Doppler test results and the need for use of direct thrombin inhibitors, not a single case of clinically significant HIT was diagnosed. Heparin associated platelet factor 4 (H-PF4) antibody test was positive in 10% and 0% of patients who developed platelet count decrease in the first and second phase, respectively. Conclusion: A very low incidence of clinically significant HIT after CABG using clinical assessment was observed and further prospective trials are warranted to confirm this observation
%K Abhinav B Chandra
%K Navneet Mittal
%K Shilpa Sambidi
%K Anuradha Belur
%K Swati Pathak
%K Himanshu Pathak and Yiqing Xu
%K Thrombocytopenia
%K Cardiopulmonary bypass surgery
%K Heparin-induced thrombocytopenia
%K Deep venous thrombosis
%U https://www.longdom.org/abstract/low-incidence-of-clinically-significant-heparin-induced-thrombocytopenia-after-cardiopulmonary-bypass-surgery-27875.html