HEPARIN-ASSOCIATED THROMBOCYTOPENIA AND THROMBOSIS AS THE CAUSE OF A FATAL THROMBUS ON EXTRACORPOREAL MEMBRANE-OXYGENATION

A rare state of acquired hypercoagulability known as heparin-associate d or heparin-induced thrombocytopenia and thrombosis (HATT, HITT) exis ts. It appears tb be caused by an antibody reaction with heparin-plate let factor 4 complexes. A mild and severe form exist, but both varieti es occur after exposure to heparin. The authors describe a fatal neona tal case of hypercoagulability on extracorporeal membrane oxygenation, and their evaluation that determined the etiology as type II HATT The y discuss the pathophysiology of HATT as weil is possible alternative anticoagulation approaches. Copyright (C) 1997 by W.B. Saunders Compan y.