Recommendations for intraoperative anticoagulation in patients with a history of HIT
| Laboratory profile . | Clinical picture . | Intraoperative anticoagulation . | |
|---|---|---|---|
| Immunologic assay . | Functional assay . | ||
| Negative | Negative | Remote HIT | UFH |
| Positive | Negative | Subacute HIT | Delay surgery; if surgery cannot be delayed, consider UFH |
| Positive | Positive | Acute HIT | Delay surgery; if surgery cannot be delayed, use an alternative anticoagulant, such as bivalirudin |
| Laboratory profile . | Clinical picture . | Intraoperative anticoagulation . | |
|---|---|---|---|
| Immunologic assay . | Functional assay . | ||
| Negative | Negative | Remote HIT | UFH |
| Positive | Negative | Subacute HIT | Delay surgery; if surgery cannot be delayed, consider UFH |
| Positive | Positive | Acute HIT | Delay surgery; if surgery cannot be delayed, use an alternative anticoagulant, such as bivalirudin |