• Jason Frost, Leila Mureebe, Pierantonio Russo, Joanne Russo, and Joseph D Tobias.
• Department of Anesthesiology, University of Missouri, Columbia, USA.
• Pediatr Crit Care Me. 2005 Mar 1; 6 (2): 216-9.

ObjectivesTo report the occurrence of heparin-induced thrombocytopenia (HIT), discuss its pathophysiology, and outline an approach to management in the pediatric intensive care unit (ICU) patient.DesignRetrospective case reports.SettingPediatric ICU in a tertiary-care center.Patients And ResultsTwo pediatric ICU patients (2 and 6 mos of age) who developed HIT in the pediatric ICU. One was receiving heparin as a flush solution through a central line and the other had full heparinization during cardiopulmonary bypass. Both had received heparin during their neonatal course and developed thrombocytopenia; however, HIT was not considered as a possible diagnosis. HIT was diagnosed using a heparin-induced platelet aggregation study. The thrombocytopenia resolved with the cessation of heparin administration. One of the patients developed a deep vein thrombosis around a femoral venous catheter.ConclusionAlthough well described in the adult literature, there have been a limited number of reports of HIT in pediatric-aged patients. Given its potential for morbidity, HIT should be considered in the differential diagnosis of thrombocytopenia in the pediatric ICU patient.

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