Uninterrupted Continuation of VV-ECMO Without

J. Cardiothorac. Vasc. Anesth. · Aug 2022

Case Reports

Uninterrupted Continuation of VV-ECMO Without Anticoagulation for 44 Days in COVID-19 ARDS: A Precarious Quandary.

Venovenous extracorporeal membrane oxygenation (VV-ECMO) has become a mainstay treatment modality for a select patient population who do not respond to conventional medical therapy suffering from severe acute respiratory distress syndrome (ARDS) due to COVID-19. This therapy necessitates the utilization of anticoagulation, whether unfractionated heparin or bivalirudin, to prevent thrombotic complications. ⋯ Herein, the authors report a case of a successful outcome in a COVID-19 ARDS patient who suffered an acute hemorrhagic complication leading to pre-emptive termination of systemic anticoagulation. The authors believe this to be one of the first such cases in the literature.

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- Sankalp P Patel, Brian J Solomon, Robert D Pascotto, Stephen E D'Orazio, Elsy V Navas, Robert J Cubeddu, and Gaston A Cudemus.
- Department of Internal Medicine, Graduate Medical Education, NCH Healthcare System, Naples, FL. Electronic address: Sankalp.Patel@nchmd.org.
- J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt B): 3193-3196.
AbstractVenovenous extracorporeal membrane oxygenation (VV-ECMO) has become a mainstay treatment modality for a select patient population who do not respond to conventional medical therapy suffering from severe acute respiratory distress syndrome (ARDS) due to COVID-19. This therapy necessitates the utilization of anticoagulation, whether unfractionated heparin or bivalirudin, to prevent thrombotic complications. Scarce are reports of VV-ECMO implementation leading to acute hemorrhage mandating cessation of anticoagulation in a patient suffering from COVID-19 ARDS. Herein, the authors report a case of a successful outcome in a COVID-19 ARDS patient who suffered an acute hemorrhagic complication leading to pre-emptive termination of systemic anticoagulation. The authors believe this to be one of the first such cases in the literature.Copyright © 2022 Elsevier Inc. All rights reserved.

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Uninterrupted Continuation of VV-ECMO Without Anticoagulation for 44 Days in COVID-19 ARDS: A Precarious Quandary.

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