TY  - BOOK
AU  - Johnson, Laura
AU  - Pratt, Alexandra K
AU  - Sarumi, Molly
AU  - Shah, Nimesh S
AU  - Sokolovic, Mladen
TI  - Platelet Count Trends and Prevalence of Heparin-Induced Thrombocytopenia in a Cohort of Extracorporeal Membrane Oxygenator Patients
SN  - 0090-3493
PY  - 2016///
KW  - *Anticoagulants/ae [Adverse Effects]
KW  - *Extracorporeal Membrane Oxygenation
KW  - *Heparin/ae [Adverse Effects]
KW  - *Platelet Count
KW  - *Thrombocytopenia/ci [Chemically Induced]
KW  - Adult
KW  - Cohort Studies
KW  - Enzyme-Linked Immunosorbent Assay
KW  - Extracorporeal Membrane Oxygenation/sn [Statistics & Numerical Data]
KW  - Female
KW  - Hospitals, Teaching
KW  - Humans
KW  - Ischemia/co [Complications]
KW  - Male
KW  - Middle Aged
KW  - Platelet Count/td [Trends]
KW  - Prevalence
KW  - Retrospective Studies
KW  - Stroke/co [Complications]
KW  - Thrombocytopenia/co [Complications]
KW  - Thrombocytopenia/ep [Epidemiology]
KW  - Thromboembolism/co [Complications]
KW  - MedStar Washington Hospital Center
KW  - Surgery/Burn Services
KW  - Surgery/Surgical Critical Care
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: Prevalence of heparin-induced thrombocytopenia and heparin-induced thrombocytopenia-related thrombosis among extracorporeal membrane oxygenator patients at our institution is relatively high. Using platelet count trends to guide decision to test for heparin-induced thrombocytopenia is not an optimal strategy in extracorporeal membrane oxygenator patients. Without a validated pretest probability clinical score, serosurveillance in a defined high-risk group of extracorporeal membrane oxygenator patients may be needed; DESIGN: Retrospective cohort study; INTERVENTIONS: None; MEASUREMENTS AND MAIN RESULTS: Demographic and clinical data were collected prospectively on all extracorporeal membrane oxygenator patients. Heparin-induced thrombocytopenia testing results and platelet count variables were obtained from the electronic medical record. We used our institutional algorithm to interpret the results of heparin-induced thrombocytopenia testing. Ninety-six extracorporeal membrane oxygenator patients met the inclusion criteria. Eight patients met the algorithm criteria for heparin-induced thrombocytopenia diagnosis and seven of those had documented thromboembolic event while on extracorporeal membrane oxygenator (prevalence of heparin-induced thrombocytopenia and heparin-induced thrombocytopenia related thrombosis, 8.3 and 7.3, respectively). Heparin-induced thrombocytopenia positive patients were younger; all underwent venoarterial extracorporeal membrane oxygenator; spent more hours on extracorporeal membrane oxygenator; had significantly higher heparin-induced thrombocytopenia enzyme-linked immunosorbent assays optical density; had a higher prevalence of thromboembolic events and reached platelet count nadir later. There was no difference in mortality between heparin-induced thrombocytopenia positive and negative patients. Comparison of platelet count trends revealed that there was no statistically significant difference between the predefined study groups; OBJECTIVES: To assess the prevalence of heparin-induced thrombocytopenia and to study platelet count trends potentially suggestive of heparin-induced thrombocytopenia in a population of extracorporeal membrane oxygenator patients; PATIENTS: Extracorporeal membrane oxygenator patients who survived longer than 48 hours from extracorporeal membrane oxygenator initiation between January 1, 2009, and December 31, 2013; SETTING: A total of 926-bed teaching hospital
UR  - https://dx.doi.org/10.1097/CCM.0000000000001869
ER  -