Hi, I cannot find reasons why heparin should not be administered to pt with anemia. How heparin can worsen anemia? Or is it because heparin increases risk of bleeding and the pt is anemic already? Is that the reason?

Thank you!

Because heparin increases bleeding tendency. The most common cause of anemia is iron loss, often due to GI bleeding.

So, it is because we think that anemia was caused by some kind of bleeding and then, of course, we don't want heparin. But what if anemia is caused by something other than bleeding? Autoimmune disease for example, or chronic kidney failure. Can heparin be administered then?

It depends on why they want the patient on heparin, is it a heparin drip or sub-q heparin. Our Dr's will often keep giving a patient sub-q heparin if they are anemic but no signs of bleeding. I've even had a rare case of a patient anemic and bleeding internally being started on a heparin drip because she had a mechanical valve. If a patient has a low hemaglobin and its been low or is dropping and the doctor wants to start heparin, there is nothing wrong with asking why they want to start it. when in doubt ask

Yes it totally depends. For example the patients I work with have end stage heart failure and are generally all anemic with Hb 7-9. We run them all on heparin for their atrial fib/valves/artificial heart pumps though. We just monitor closely and shut it off if the Hb is dropping. "Stable anemia" of chronic disease is not necessarily an absolute contraindication to heparinization.

Thank you so much! Your comments were very helpful!