Objectives: Heparin-induced thrombocytopenia
is a recognized concern in patients on extracorporeal life support. The purpose of this study was to evaluate the applicability of an enzyme-linked immunosorbent assay optical density threshold less than 1 to rule out heparin-induced thrombocytopenia
in patients on extracorporeal membrane oxygenation
Retrospective, single-center study.
Patients were recruited from a prospectively maintained database of all patients on extracorporeal membrane oxygenation
from 2012 to 2018 at a tertiary referral center.
Forty-seven patients on extracorporeal membrane oxygenation
The primary objective was to evaluate the application of enzyme-linked immunosorbent assay optical density thresholds and the serotonin release assay in patients on extracorporeal membrane oxygenation
. Patients were divided into two cohorts, serotonin release assay negative and serotonin release assay positive. In order to perform a sensitivity and specificity analysis of enzyme-linked immunosorbent assay optical density thresholds, heparin-induced thrombocytopenia
negative was defined as an optical density less than 1.0 and heparin-induced thrombocytopenia
positive as an optical density greater than or equal to 1.0.
Measurements and Main Results:
Utilizing the prespecified optical density thresholds, a specificity and negative predictive value of 89% and 95% were achieved, respectively.
This assessment has helped to identify optical density thresholds for patients undergoing extracorporeal membrane oxygenation
. Our data suggest that an optical density threshold of 1.0 may aid clinicians in objectively ruling out heparin-induced thrombocytopenia
without sending a confirmatory serotonin release assay. Increasing the optical density threshold to 1.0 resulted in a high specificity and negative predictive value.