Treatments for Heparin Induced Thrombocytopenia

Thrombocytopenia is a condition that lowers the number of platelets in the blood, states Mayoclinic.com. These platelets are a primary source for blood clotting. Clotting is an essential function of the blood that prevents us from bleeding too much, which can be fatal if not treated. However, too much clotting, or thrombosis, can also be life threatening.

Heparin

• Heparin, a medication used for anticoagulation purposes, treats patients who are known to have increased risk for developing thrombosis. Sometimes, heparin can cause a condition known as heparin induced thrombocytopenia (HIT). Essentially, the heparin causes the thrombocytopenia and puts the patient at risk of severe bleeding.

HIT Symptoms

• According to Mayoclinic.com, symptoms include easy bruising, bloody bowel movements, excessive menstruation, excessive bleeding or hemorrhaging during surgical procedures, bleeding from nose or gums with no known origin and petechiae, which look like purple dots on the skin from underlying bleeding.

Treatment Start

• According to the American Association of Critical Care Nurses (AACN), when patients have been diagnosed with HIT, it is absolutely imperative that their heparin treatment be stopped immediately. Unfortunately, this will not completely treat the condition.

Treatment with medications

• Typically, alternative anticoagulants, specifically direct thrombin inhibitors such as agatroban and lepirudin, which are approved by the Food and Drug Administration to treat HIT are used. It is not recommended that patients stop their anticoagulation therapy abruptly, since it can put them into a state of hypercoaguability where they can run the risk of developing a life-threatening clot. Therefore, patients with HIT are taken off of the heparin and put onto another anticoagulant, to keep their blood clotting factors at normal levels.

Monitoring

• As part of the treatment for HIT, medical and nursing staff must regularly monitor the patient's platelet counts when HIT is suspected or confirmed. Daily (or more) laboratory draws should be completed and reviewed to determine the effectiveness of treatment.