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Bonnie Gandy
Is HIT caused by the Concentration of Heparin?

Would someone please explain to me how heparin induced thrombocytopenia is not caused by flushing the catheter with high concentrations of heparin.  (I thought it could)  For example, using 5cc of 10u/cc heparin, as compared to 5cc of 100u/cc heparin will not be significant.  My argument is that if a nurse is flushing a triple lumen twice daily, that's 3,000 units of heparin and I feel this is too much!  What is everyone else doing?  And can HIT be caused by this?  Or does the resident have to have problems to begin with?  I need some help to understand this!  Thanks!

Bonnie Gandy, RN, BSN, BA, CRNI

lynncrni
HIT is ***not***
HIT is ***not*** dose-dependent. This is an immunological reaction and can occur with 10 units per mL as well as higher doses. Higher doses should be avoided though because the overspill from the catheter lumen will have an impact upon coagulation. See the attached file of an article in a recent JAVA issue. 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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