Review Article

Heparin-Induced Thrombocytopenia and Extracorporeal Membrane Oxygenation: A Case Report and Review of the Literature

^* Cardiac Intensive Care Unit
^† Hematology Unit, Schneider Children’s Medical Center of Israel, Petah Tiqwa, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Address correspondence to: Uri Pollak, MD, Cardiac Intensive Care Unit, Schneider Children’s Medical Center of Israel, Petah Tiqwa 49202, Israel. E-mail: uri.pollak@gmail.com

Received: 12 October 2010
Accepted: 21 January 2011

Abstract

Heparin-induced thrombocytopenia (HIT) is an immune-mediated coagulation side effect of heparin therapy characterized by thrombocytopenia and by a paradoxical prothrombotic state following heparin exposure when thrombotic or thromboembolic events accurse, the condition is classified as Heparin-induced thrombocytopenia with thrombosis (HITT). We report a case of HITT with evidence of small-vessel arterial thrombosis in a 5-day-old newborn receiving extracorporeal membrane oxygenation (ECMO) for congenital diaphragmatic hernia, and our attempt of bivalirudin alternative treatment. We also review previous reports regarding HIT and ECMO with the alternative management in this unique population.