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- Joshua A Krieger, Jenna R Wixon-Genack, Samuel P Mandell, and James A Town.
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA. Electronic address: jakrieger@gmail.com.
- Chest. 2021 Aug 1; 160 (2): e189-e193.
Case PresentationA 57-year-old man who had been intubated and placed on venovenous extracorporeal membrane oxygenation for hypoxemic respiratory failure due to COVID-19 pneumonia was transferred to our facility. He underwent anticoagulation with IV heparin titrated to an anti-Factor Xa goal of 0.1 to 0.3 international unit/mL. Over extracorporeal membrane oxygenation days 13 to 17, his WBC count rose from 17,500 to 47,000 cells/μL. He simultaneously experienced the development of fluid-refractory shock that required multiple vasopressors and received stress-dose hydrocortisone when his WBC was 30,000 cells/μL. He remained afebrile and was started on broad-spectrum antimicrobials that included antifungal and anthelminthic therapy.Published by Elsevier Inc.
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