ABSTRACT
Heparin-induced thrombocytopenia (HIT) presents a unique situation: heparin causes the very problems its use was intended to prevent, namely, such complications as pulmonary embolism, stroke, and limb gangrene. Furthermore, several treatment paradoxes pose serious management pitfalls (Table I). This chapter summarizes our treatment approach, with emphasis on practical management issues. We view HIT as a syndrome of increased thrombin generation. Accordingly, we emphasize the use of rapidly acting anticoagulant drugs that control thrombin generation in HIT.
