Author/Authors :
Steinlechner, Barbara Division of Cardiothoracic and Vascular Anesthesia - Department of Anesthesia - Intensive Care Medicine and Pain Medicine - Medical University Vienna - Vienna, Austria , Kargl, Gabriele Division of Cardiothoracic and Vascular Anesthesia - Department of Anesthesia - Intensive Care Medicine and Pain Medicine - Medical University Vienna - Vienna, Austria , Schl ̈ommer, Christine Division of Cardiothoracic and Vascular Anesthesia - Department of Anesthesia - Intensive Care Medicine and Pain Medicine - Medical University Vienna - Vienna, Austria , Holaubek, Caroline Division of Cardiothoracic and Vascular Anesthesia - Department of Anesthesia - Intensive Care Medicine and Pain Medicine - Medical University Vienna - Vienna, Austria , Scheriau, Georg Division of Cardiothoracic and Vascular Anesthesia - Department of Anesthesia - Intensive Care Medicine and Pain Medicine - Medical University Vienna - Vienna, Austria , Eichinger, Sabine Division of Hematology and Hemostaseology - Department of Medicine I - Medical University Vienna - Vienna, Austria , Gratz, Johannes Division of General Anesthesia and Intensive Care Medicine - Department of Anesthesia - Intensive Care Medicine and Pain Medicine - Medical University Vienna - Vienna, Austria , R ̈ossler, Bernhard Division of General Anesthesia and Intensive Care Medicine - Department of Anesthesia - Intensive Care Medicine and Pain Medicine - Medical University Vienna - Vienna, Austria
Abstract :
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 thepresence of circulating HIT antibodies 12 days after ECMO initiation. Replacement of the ECMO system including cannulasresulted in the normalization of the platelet count. However, the clinical situation did not improve, and the patient died 9 dayslater. Careful consideration of anticoagulant therapy and ECMO circuit, as well as routine HIT antibody testing, may prevent afatal course in ECMO-supported COVID-19 patients
Keywords :
Heparin-Coated ECMO Cannulas , Thrombocytopenia , COVID-19 Patients , HIT , Extracorporeal membrane oxygenation (ECMO)