Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients?

Barbara Steinlechner; Gabriele Kargl; Christine Schlömmer; Caroline Holaubek; Georg Scheriau; Sabine Eichinger; Johannes Gratz; Bernhard Rössler

doi:10.1155/2021/6624682

Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients?

Case Reports Immunol. 2021 Jun 4:2021:6624682. doi: 10.1155/2021/6624682. eCollection 2021.

Authors

Barbara Steinlechner¹, Gabriele Kargl¹, Christine Schlömmer¹, Caroline Holaubek¹, Georg Scheriau¹, Sabine Eichinger², Johannes Gratz³, Bernhard Rössler³

Affiliations

¹ Division of Cardiothoracic and Vascular Anesthesia, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria.
² Division of Hematology and Hemostaseology, Department of Medicine I, Medical University Vienna, Vienna, Austria.
³ 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 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.

Publication types

Case Reports