Efficacy of thromboelastography in the management of anticoagulation for veno-venous extracorporeal membrane oxygenation in a coronavirus disease 2019 patient: A case report.

Medicine
Ryosuke NakashimaHiroyuki Tsutsui

Abstract

In coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome refractory to optimal conventional management, we should consider the indication for veno-venous extracorporeal membrane oxygenation (V-V ECMO). Growing evidence indicates that COVID-19 frequently causes coagulopathy, presenting as hypercoagulation and incidental thrombosis. For these reasons, a multifactorial approach with several anticoagulant markers should be considered in the management of anticoagulation using heparin in COVID-19 patients on V-V ECMO. A 48-year-old man was infected with COVID-19 with a worsening condition manifesting as acute respiratory distress syndrome. He was refractory to conventional therapy, thus we decided to introduce V-V ECMO. We used heparin as an anticoagulant therapy for V-V ECMO and adjusted the doses of heparin by careful monitoring of the activated clotting time (ACT) and activated partial thromboplastin time (APTT) to avoid both hemorrhagic and thrombotic complications. We controlled the doses of heparin in the therapeutic ranges of ACT and APTT, but clinical hemorrhaging and profound elevation of coagulant marker became apparent. Using thromboelastography (TEG; Haemonetics) in addition to ACT and APT...Continue Reading

References

Jan 1, 1987·Journal of Clinical Monitoring·B D SpiessA D Ivankovich
Jun 13, 2013·Anesthesia and Analgesia·Herbert Schöchl, Christoph J Schlimp
Jan 18, 2015·Transfusion Medicine Reviews·Deirdre A MurphyAmanda K Davis
Jan 1, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Mauro PanigadaLuciano Gattinoni
Feb 29, 2020·The New England Journal of Medicine·Wei-Jie GuanUNKNOWN China Medical Treatment Expert Group for Covid-19
Apr 25, 2020·Circulation·Julien PoissyUNKNOWN Lille ICU Haemostasis COVID-19 Group
Apr 28, 2020·Journal of Thrombosis and Haemostasis : JTH·Jecko ThachilToshiaki Iba
Apr 28, 2020·Blood·Jean M Connors, Jerrold H Levy

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Related Papers

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Zachary R BergmanMelissa E Brunsvold
ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Lauren A RaffTrista S Reid
The Journal of Critical Care Medicine
Amelia Lucy FitzgeraldAdam Trevor Eslick
ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Julien GuihaireOlaf Mercier
© 2021 Meta ULC. All rights reserved