Hematological Consults in the Neuro-ICU

Join Dr. Camila Masias, a hematology and oncology physician with Miami Cancer Institute, in this discussion on hypercoagulable studies in critically ill patients. We will focus on identifying and managing heparin-induced thrombocytopenia (HIT) as a rare cause of thrombocytopenia.

Target Audience

Adult and Pediatric Neurologists, Neurosurgeons, Stroke Neurologists, Neuroradiologists, Diagnostic Radiologists, Critical Care Physicians, Neurointensivists, Emergency Medicine Physicians, Internal Medicine Physicians, Interventional Neuroradiologists, Family Physicians, General Internists, Rehabilitation and Pain Management Specialists, Physician Assistants, Critical Care and Neuroscience Nurses, Neurosurgery Nurses, Nurse Practitioners, as well as other specialists interested in the field of neuroscience.

Learning Objectives

  • Assess when hypercoagulable studies are needed in patients with stroke and implement appropriate follow-up with abnormal hypercoagulable test result.
  • Identify and manage heparin-induced thrombocytopenia (HIT) as a rare cause of thrombocytopenia in the critically ill patient. 
  • Utilize the 4T score in patients with suspected HIT.
Additional information
Bibliography: 

Alakbarzade V, Taylor A, Scully M, Simister R. Chandratheva A. Utility of current thrombophilia screening in young patients with stroke and TIA. Stroke and Vascular Neurology 2018; 3:e000169. 

Arepally G. Heparin-Induced Thrombocytopenia. Blood 2017; 129(21): 2864-2872. 

Gavva C, Johnson N, De Simone N, Sarode R. An Audit of Thrombophilia Testing in Patients with Ischemic Stroke or Transient Ischemic Attack: The Futility of Testing. J Stroke Cerebrovasc Dis. 2018 Nov;27(11):3301-3305.

Omran SS, Lerario MP, Gialdini G, Merkler AE, Moya A, Chen ML, Kamel H, DeSancho M, Navi BB. Clinical Impact of Thrombophilia Screening in Young Adults with Ischemic Stroke. J Stroke Cerebrovasc Dis. 2019 Apr;28(4):882-889.

Warkentin T. Heparin-Induced Thrombocytopenia in Critically Ill Patients. Semin Thromb Hemost 2015;41:49-60.

Course Summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
Course opens: 
08/01/2020
Course expires: 
09/30/2022

Camila Masias, M.D., MPH
Medical Oncologist and Benign Hematologist
Miami Cancer Institute
Baptist Health Quality Network
Baptist Health Medical Group
Baptist Health South Florida 

Camila Masias, M.D., MPH, faculty for this educational activity, has indicated that she is a consultant with Rigel Pharmaceuticals and has indicated that the presentation or discussion will not include off-label or unapproved product usage. 

This online course is a highlight from the 2019 Miami Neuroscience Symposium. The following is the symposium planning committee.

Kevin Abrams, M.D., indicated that he is a consultant for Keystone Heart. He is also a shareholder in Cleerly and Keystone Heart.

Guilherme Dabus, M.D., indicated that he is a consultant for Microvention, Medtronic, Cernovus and Penumbra. He is a proctor for Medtronic. Dr. Dabus is also a shareholder in Surpass Medical/Stryker, InNeuroCo, Medina Medical/Medtronic, eLum, Three Rivers Medical and RIST.

Felipe De Los Rios La Rosa, M.D., has no relevant financial relationship with ineligible companies* to disclose.

Karel Fuentes, M.D., has no relevant financial relationship with ineligible companies* to disclose.

Bruno Gallo, M.D., indicated that he is a consultant for Surgimon, Inc. He is on the speakers' bureau for Teva, Acadia, Adamas and Sunovion. Dr. Gallo has also received grant/research support from St. Jude Medical and Medtronic.

Italo Linfante, M.D., indicated that he is a consultant for Medtronic and Stryker. Dr. Linfante is also a shareholder in InNeuroCo and Three Rivers Medical.

Alberto Pinzon-Ardila, M.D., PH.D., indicated that he is on the speakers' bureau for Sunovion and UCB.

All of the relevant financial relationships listed for these individuals have been mitigated.

Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose with ineligible companies*.  

*Ineligible companies -- Companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
              
Baptist Health South Florida designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
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