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Uptodate Reference Title
Platelet count monitoring for heparin-induced thrombocytopenia (HIT) in patients receiving anticoagulation
Platelet count monitoring for heparin-induced thrombocytopenia (HIT) in patients receiving anticoagulation
Risk of HIT
Population
Platelet count monitoring[1]
Low (<0.1%)
Medical or obstetric patients receiving LMW heparin
Minor surgery or minor trauma patients receiving LMW heparin
Patients receiving fondaparinux or an anticoagulant not associated with development of HIT
Suggest against monitoring
Intermediate (≥0.1 to 1%)
Medical or obstetric patients receiving UFH
Major surgery or major trauma patients receiving LMW heparin
Suggest monitoring every 2 to 3 days from day 0 through day 14
High (>1%)
Major surgery or major trauma patients receiving UFH
All patients treated with anticoagulation should have a baseline platelet count prior to starting the anticoagulant. For patients receiving UFH plus another anticoagulant, use the risk for UFH. The risk of HIT is higher for therapeutic dose UFH than for lower doses (including heparin flushes). More or less frequent monitoring may be reasonable depending on the judgement of the treating clinicians. Refer to UpToDate and the 2018 ASH guidelines for details and supporting evidence.
Cuker A, Arepally GM, Chong BH, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood Advances 2018; 2:3360.