In suspected HIT, what is the recommended management?

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Multiple Choice

In suspected HIT, what is the recommended management?

Suspected HIT means the heparin-triggered immune reaction is driving a dangerous prothrombotic state, so the immediate priority is to remove the trigger and prevent further clotting. Stop all heparin exposure right away, including in lines or flushes. Then initiate a non-heparin anticoagulant such as a direct thrombin inhibitor (for example, argatroban or bivalirudin) or another approved non-heparin agent to continue protection against thrombosis while the platelet count recovers. Platelet transfusions are not routinely given in HIT because they can promote additional clotting in this setting. Warfarin is not started right away; once the patient is stabilized on a non-heparin anticoagulant and platelets have recovered, warfarin can be introduced with careful bridging, since starting warfarin during active HIT can worsen microvascular thrombosis.

Suspected HIT means the heparin-triggered immune reaction is driving a dangerous prothrombotic state, so the immediate priority is to remove the trigger and prevent further clotting. Stop all heparin exposure right away, including in lines or flushes. Then initiate a non-heparin anticoagulant such as a direct thrombin inhibitor (for example, argatroban or bivalirudin) or another approved non-heparin agent to continue protection against thrombosis while the platelet count recovers. Platelet transfusions are not routinely given in HIT because they can promote additional clotting in this setting. Warfarin is not started right away; once the patient is stabilized on a non-heparin anticoagulant and platelets have recovered, warfarin can be introduced with careful bridging, since starting warfarin during active HIT can worsen microvascular thrombosis.

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