HIT...short notice (help!)

[RNin2007]

I am putting this here because I am hoping someone can help me better understand this by tomorrow morning ...if I can't get a good answer, I just will leave it out of my presentation.

I'm trying to get a better understanding of HIT...Heparin Induced Thrombocytopenia. Everything I am finding is really hard to understand...can someone help me simplify it? For instance, this is what I found:

HIT, which usually develops after a patient has been on heparin for 5 or more days, may develop sooner if there has been previous heparin exposure. Heparin binds to platelet factor 4 (PF4), forming a highly reactive antigenic complex on the surface of platelets and on endothelial cell surfaces, thereby increasing the number of targets for heparin-dependent antibodies. Susceptible patients then develop an antibody (IgG) to the heparin-PF4 antigenic complex. Once produced, immunoglobulins, usually IgG, bind to the heparin-PF4 immune complex on the platelet surface. The Fc portion of the IgG then activates the platelets by binding to platelet Fc receptors.

Thrombocytopenia develops as the reticuloendothelial system consumes activated platelets, platelet microaggregates, and IgG-coated platelets. Most devastating, however, is the thrombotic state that develops as a result of platelet activation and the generation of procoagulant microparticles, and an additional increase in thrombin generation.

accck, lol. Can this be simplified? Or is this as pretty as it's gettin?

THANK YOU for any help!!!

~J

[zacarias, ASN, RN]

Yeah too complicated. Basically just talk about how heparin can make platelets antigenic (foreign) to the body and so it makes antibodies to "label" it for the body (spleen etc...) to get rid of them. Unfortunately all this immune activity leads to paradoxical hypercoaguable condition.

Maybe start out by saying our immune system is there to help us but in certain disease states, it becomes harmful and even deadly. You can could give examples of autoimmune states (lupus, RA etc) and then segue into your HIT explanation...

Just some ideas...

[RNin2007]

Thanks so much! That does sound much better...I will do just that. And thanks for the suggestion of using RA, lupus...good analogy.

Have a great day,

~J

[zacarias, ASN, RN]

J,

How did your presentation go?

[RNin2007]

Thank you for asking, it actually went really well. I didn't think to pull out my Tabers for a definition on that, and after reading your post, that is exactly what I did....I also used your analogy. Some of the pictures I had were pretty gruesome...not something i'd ever like to experience for sure. Our whole pres was on CVAD and keeping them patent, evidenced based practice, comparing policies/procedures between hospitals, etc. Group effort.

And thanks to an email interview with another awesome member on this site, she gave me some great info to add as well. :)

~J