Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients?
Extracorporeal membrane oxygenation (ECMO) is often used in the management of COVID-19-related severe respiratory failure. We report the first case of a patient with COVID-19-related ARDS on ECMO support who developed symptoms of heparin-induced thrombocytopenia (HIT) in the absence of heparin thera...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Immunology |
| Online Access: | http://dx.doi.org/10.1155/2021/6624682 |
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| author | Barbara Steinlechner Gabriele Kargl Christine Schlömmer Caroline Holaubek Georg Scheriau Sabine Eichinger Johannes Gratz Bernhard Rössler |
| author_facet | Barbara Steinlechner Gabriele Kargl Christine Schlömmer Caroline Holaubek Georg Scheriau Sabine Eichinger Johannes Gratz Bernhard Rössler |
| author_sort | Barbara Steinlechner |
| collection | DOAJ |
| description | Extracorporeal membrane oxygenation (ECMO) is often used in the management of COVID-19-related severe respiratory failure. We report the first case of a patient with COVID-19-related ARDS on ECMO support who developed symptoms of heparin-induced thrombocytopenia (HIT) in the absence of heparin therapy. A low platelet count of 61 G/L was accompanied by the presence of circulating HIT antibodies 12 days after ECMO initiation. Replacement of the ECMO system including cannulas resulted in the normalization of the platelet count. However, the clinical situation did not improve, and the patient died 9 days later. Careful consideration of anticoagulant therapy and ECMO circuit, as well as routine HIT antibody testing, may prevent a fatal course in ECMO-supported COVID-19 patients. |
| format | Article |
| id | doaj-art-cabf6ed7e45d401b88f1164fb2255ea2 |
| institution | OA Journals |
| issn | 2090-6609 2090-6617 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Immunology |
| spelling | doaj-art-cabf6ed7e45d401b88f1164fb2255ea22025-08-20T02:19:37ZengWileyCase Reports in Immunology2090-66092090-66172021-01-01202110.1155/2021/66246826624682Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients?Barbara Steinlechner0Gabriele Kargl1Christine Schlömmer2Caroline Holaubek3Georg Scheriau4Sabine Eichinger5Johannes Gratz6Bernhard Rössler7Division of Cardiothoracic and Vascular Anesthesia, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, AustriaDivision of Cardiothoracic and Vascular Anesthesia, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, AustriaDivision of Cardiothoracic and Vascular Anesthesia, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, AustriaDivision of Cardiothoracic and Vascular Anesthesia, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, AustriaDivision of Cardiothoracic and Vascular Anesthesia, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, AustriaDivision of Hematology and Hemostaseology, Department of Medicine I, Medical University Vienna, Vienna, AustriaDivision of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, AustriaDivision of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, AustriaExtracorporeal membrane oxygenation (ECMO) is often used in the management of COVID-19-related severe respiratory failure. We report the first case of a patient with COVID-19-related ARDS on ECMO support who developed symptoms of heparin-induced thrombocytopenia (HIT) in the absence of heparin therapy. A low platelet count of 61 G/L was accompanied by the presence of circulating HIT antibodies 12 days after ECMO initiation. Replacement of the ECMO system including cannulas resulted in the normalization of the platelet count. However, the clinical situation did not improve, and the patient died 9 days later. Careful consideration of anticoagulant therapy and ECMO circuit, as well as routine HIT antibody testing, may prevent a fatal course in ECMO-supported COVID-19 patients.http://dx.doi.org/10.1155/2021/6624682 |
| spellingShingle | Barbara Steinlechner Gabriele Kargl Christine Schlömmer Caroline Holaubek Georg Scheriau Sabine Eichinger Johannes Gratz Bernhard Rössler Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients? Case Reports in Immunology |
| title | Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients? |
| title_full | Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients? |
| title_fullStr | Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients? |
| title_full_unstemmed | Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients? |
| title_short | Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients? |
| title_sort | can heparin coated ecmo cannulas induce thrombocytopenia in covid 19 patients |
| url | http://dx.doi.org/10.1155/2021/6624682 |
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