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Presse Med ; 36(5 Pt 1): 786-93, 2007 May.
Artigo em Francês | MEDLINE | ID: mdl-17303370

RESUMO

INTRODUCTION: Heparin-induced thrombocytopenia (HIT) is a serious immune complication of heparin therapy and presents a risk of severe thromboembolic events. Withdrawal of heparin together with administration of an alternative antithrombotic agent is always necessary in patients with suspected HIT. Diagnosis of this complication, however, is often difficult, particularly in hospitalized patients. The aim of this study was to evaluate the impact of multidisciplinary consultation on the appropriate prescription of danaparoid, widely used as an alternative antithrombotic treatment in HIT. MATERIAL AND METHODS: Multidisciplinary consultation between clinician, hematologist, and pharmacist called for reassessment of the HIT diagnosis at day 3 and between day 3 and 10 after the beginning of danaparoid treatment. Continuation or stopping treatment depended on their joint conclusion. All danaparoid prescriptions were evaluated according to this procedure for one year. RESULTS: HIT was suspected in 26 in-patients. The multidisciplinary approach made it possible to reassess the HIT diagnosis on day 3 and stop the alternative treatment in 42.3% of cases. Danaparoid use decreased by 52% compared with the previous year. CONCLUSION: Multidisciplinary consultations between clinician, hematologist, and pharmacist appear useful for minimizing inappropriate prescription of this alternative treatment in cases of suspected HIT.


Assuntos
Anticoagulantes/uso terapêutico , Sulfatos de Condroitina/uso terapêutico , Dermatan Sulfato/uso terapêutico , Prescrições de Medicamentos , Fibrinolíticos/uso terapêutico , Heparina/efeitos adversos , Heparitina Sulfato/uso terapêutico , Trombocitopenia/induzido quimicamente , Trombocitopenia/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Heparina/imunologia , Heparina/uso terapêutico , Hospitalização , Humanos , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Contagem de Plaquetas , Probabilidade , Encaminhamento e Consulta , Estudos Retrospectivos , Trombocitopenia/sangue , Trombocitopenia/etiologia , Trombocitopenia/prevenção & controle , Fatores de Tempo
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