Treatment
Figure 3. Acute or Subacute HIT in Special Situations Bivalirudin (2C)
Urgent cardiac surgery
Nonurgent cardiac surgery
PCI Renal replacement Pregnancy * Not available in the US.
Cardiac surgery (+) antibodies
Cardiac surgery (-) antibodies
Cardiac cath or PCI (-) antibodies
thrombosis and normal renal function
Acute non-HIT
Renal replacement or catheter locking
Figure 4. Past History of HIT Nonheparin
Delay surgery if possible until HIT has resolved and HIT antibodies are negative (2C)
Bivalirudin (2B) or argatroban (2C)
danaparoid* (2C) Argatroban or
If unavailable: lepirudin or fondaparinux (2C)
Danaparoid* (2C)
anticoagulants (2C)
Short-term heparin (2C)
Bivalirudin (2B) or argatroban (2C)
Fondaparinux (full dose) and transition to VKA (2C)
Regional citrate (2C)
