Digital Commons Network^™

The Standard Of Care Is Standard For A Reason: Commentary On "Optimal Dosing Of Heparin For Prophylactic Anticoagulation In Critically Ill Covid-19 Patients: A Systematic Review And Meta-Analysis Of Randomized Clinical Trials", Victoria Milano, Jacob Hurt, Nathan D. Nielsen

Pathology Research and Scholarship

No abstract provided.

Impact Of A Multidisciplinary Workflow On Safety And Management Of Patients With Heparin-Induced Thrombocytopenia, Sheh-Li Chen, Andrew P. Stivers, Jonathan D. Cicci, Tanner L. Hedrick, Marian A. Rollins-Raval, Raj S. Kasthuri, Kalynn A. Northam

Pathology Research and Scholarship

PURPOSE: Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin administration. Management strategies are complex and include discontinuing heparin products, initiating alternative anticoagulants, interpreting laboratory test results, documenting heparin allergies, and providing patient education. Medication error reports and a retrospective review conducted at an academic medical center revealed an opportunity for a quality improvement initiative and led to the creation of a multidisciplinary workflow for the management of HIT. In a pre-post study, the impact of the multidisciplinary workflow on the safety and management of HIT was evaluated.

METHODS: The preimplementation group consisted of adult patients tested for suspected HIT …

Therapeutic Plasma Exchange And Intravenous Immune Globulin In The Treatment Of Heparin-Induced Thrombocytopenia: A Systematic Review, Chinonso Onuoha, Karen D. Barton, Edward C C Wong, Jay S. Raval, Marian A. Rollins-Raval, Tina A. Ipe, Joseph E. Kiss, Leonard I. Boral, Jill Adamksi, Nicole D. Zantek, Oluwatoyosi A. Onwuemene

Pathology Research and Scholarship

BACKGROUND: Immunomodulatory strategies in heparin-induced thrombocytopenia (HIT) include the use of intravenous immune globulin (IVIG) and therapeutic plasma exchange (TPE). The optimal application of these therapies is unknown and outcomes data are limited. We investigated treatment categories and laboratory and clinical outcomes of IVIG and/or TPE in HIT with a systematic literature review.

STUDY DESIGN AND METHODS: We searched MEDLINE, Embase, and Web of Science through December 2019 for studies combining controlled vocabulary and keywords related to thrombocytopenia, heparin, TPE, and IVIG. The primary outcome was treatment indication. Secondary outcomes were platelet recovery, HIT laboratory parameters, heparin re-exposure, and post-treatment …

Heparin-Induced Thrombocytopenia Associated With Collection Of Hematopoietic Progenitor Cells By Apheresis, Jay S. Raval, Yara A. Park, Irina Perjar, Marshall A. Mazepa, Benjamin G. Vincent, Alice D. Ma, Marian A. Rollins-Raval

Pathology Research and Scholarship

Heparin-induced thrombocytopenia (HIT) can occur following exposure to heparin and is characterized by thrombocytopenia with increased risk for thrombosis. This condition is mediated by formation of immunoglobulin G antibodies against platelet factor 4/heparin complexes that can subsequently lead to platelet activation. Herein, we detail the clinical and laboratory findings, treatments, and outcomes of two patients who developed HIT and thrombosis after undergoing collection of hematopoietic progenitor cells by apheresis (HPC-A) for autologous HPC transplant. Given that heparin may be used during HPC-A collections, these cases emphasize the importance of prompt consideration of HIT in patients that develop thrombocytopenia and thrombosis …