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10.1007/s10047-020-01203-x

http://scihub22266oqcxt.onion/10.1007/s10047-020-01203-x
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32789604!8825665!32789604
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suck abstract from ncbi

pmid32789604      J+Artif+Organs 2021 ; 24 (2): 277-281
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  • Heparin-induced thrombocytopenia in COVID-19 patients with severe acute respiratory distress syndrome requiring extracorporeal membrane oxygenation: two case reports #MMPMID32789604
  • Bidar F; Hekimian G; Martin-Toutain I; Lebreton G; Combes A; Frere C
  • J Artif Organs 2021[Jun]; 24 (2): 277-281 PMID32789604show ga
  • Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is increasingly used in Coronavirus disease-19 (COVID-19) patients with the most severe forms of acute respiratory distress syndrome (ARDS). Its use is associated with a significant hemostatic challenge, especially in COVID- 19 patients who have been demonstrated to otherwise present a COVID-19-associated coagulopathy. The systematic use of unfractionated heparin therapy to prevent circuit thrombosis is warranted during ECMO support. The clinical presentation and management of heparin-induced thrombocytopenia, which is a rare but life-threatening complication of heparin therapy, has not been described in those patients yet. We report herein two cases of laboratory-confirmed HIT in COVID-19 patients with severe ARDS admitted to our intensive care unit for VV-ECMO support and the successful use of argatroban as an alternative therapy. We also provide a brief literature review of best evidence for managing such patients. The diagnosis and management of HIT is particularly challenging in COVID-19 patients receiving ECMO support. An increased awareness is warranted in those patients who already present a procoagulant state leading to higher rates of thrombotic events which can confuse the issues. Argatroban seems to be an appropriate and safe therapeutic option in COVID-19 patients with HIT while on VV-ECMO.
  • |*Extracorporeal Membrane Oxygenation[MESH]
  • |Adult[MESH]
  • |Anticoagulants/*adverse effects[MESH]
  • |COVID-19/*therapy[MESH]
  • |Female[MESH]
  • |Heparin/*adverse effects[MESH]
  • |Humans[MESH]
  • |Intensive Care Units[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Respiratory Distress Syndrome/*therapy[MESH]


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