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World J Crit Care Med. Aug 4, 2015; 4(3): 202-212
Published online Aug 4, 2015. doi: 10.5492/wjccm.v4.i3.202
Heparin induced thrombocytopenia in critically ill: Diagnostic dilemmas and management conundrums
Sachin Gupta, Ravindranath Tiruvoipati, Cameron Green, John Botha, Huy Tran
Sachin Gupta, Ravindranath Tiruvoipati, Cameron Green, John Botha, Department of Intensive Care Medicine, Frankston Hospital, Frankston VIC 3199, Australia
Sachin Gupta, Ravindranath Tiruvoipati, John Botha, School of Public Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria 3800, Australia
Huy Tran, Department of Oncology, Frankston Hospital, Frankston VIC 3199, Australia
Author contributions: Gupta S contributed to conception and design, drafting the manuscript and revising it critically for important intellectual content; Tiruvoipati R, Green C and Botha J contributed to drafting the manuscript and revising it critically for important intellectual content; Tran H contributed to conception and design, drafting the manuscript and revising it critically for important intellectual content, overall supervision; all authors had given final approval of the version to be published.
Conflict-of-interest statement: None of the authors have any conflicts of interests (including but not limited to commercial, personal, political. Intellectual, or religious interests) in relation to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ravindranath Tiruvoipati, Associate Professor, Department of Intensive Care Medicine, Frankston Hospital, 2 Hastings Rd, Frankston VIC 3199, Australia. travindranath@hotmail.com
Telephone: +61-4-31279347 Fax: +61-3-97847398
Received: October 3, 2014
Peer-review started: October 3, 2014
First decision: December 26, 2014
Revised: February 25, 2015
Accepted: May 11, 2015
Article in press: May 14, 2015
Published online: August 4, 2015
Processing time: 318 Days and 9.1 Hours
Core Tip

Core tip: Thrombocytopenia is common in critically ill patients. While there are several causes of thrombocytopenia, heparin induced thrombocytopenia syndrome (HITS) is an uncommon cause often difficult to diagnose and manage. This article summarises the current diagnostic techniques and management options with a focus on critically ill patients with HITS.