Suspected Heparin-Induced Thrombocytopenia in a COVID-19 Patient on Extracorporeal Membrane Oxygenation Support: A Case Report

Background: Extracorporeal membrane oxygenation (ECMO) support can be life-saving in critically ill COVID-19 patients. However, there are many complications associated with this procedure, including Heparin-induced thrombocytopenia (HIT.) Despite its rarity in ECMO cases, HIT can lead to devastating...

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Bibliographic Details
Published in:Thrombosis Journal 2020
Main Authors: Phan, Xuan T, Nguyen, Tuan Huu, Tran, Tung T, Huynh, Thu-Hien T, Hoang, Thuy-Ha T, Nguyen, Vinh-Chau V, Pham, Thao N T
Format: Report
Language:English
Subjects:
Coronaviruses
COVID-19
Extracorporeal membrane oxygenation
Thrombocytopenia
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Summary:Background: Extracorporeal membrane oxygenation (ECMO) support can be life-saving in critically ill COVID-19 patients. However, there are many complications associated with this procedure, including Heparin-induced thrombocytopenia (HIT.) Despite its rarity in ECMO cases, HIT can lead to devastating consequences and is difficult to manage. Case presentation: In this report, we present a case of a COVID-19 patient on ECMO support who was diagnosed with HIT and required intensive treatment. Initially, HIT was only suspected due to newly-developed thrombocytopenia and oxygenator dysfunction, with thrombi observed later. Regarding his treatment, since there was no recommended replacement to heparin available to us at the time of diagnosis, we decided to use rivaroxaban temporarily. No adverse events were recorded during that period. The patient was able to make a full recovery. Conclusion: HIT may jeopardize patient’s care during ECMO. As COVID-19 may bring about a surge in the number of patients requiring ECMO support, we need consented guidance to optimize treatment in this specific situation.
DOI:10.21203/rs.3.rs-50546/v4