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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Bibliographic Details
Main Authors: Barbara Steinlechner, Gabriele Kargl, Christine Schlömmer, Caroline Holaubek, Georg Scheriau, Sabine Eichinger, Johannes Gratz, Bernhard Rössler
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Immunology
Online Access:http://dx.doi.org/10.1155/2021/6624682
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Summary: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.
ISSN:2090-6609
2090-6617