Multiple thromboses,including intracardiac thrombi,accompanied by HIT during ECMO successfully treated with NOACs: A case report

Abstract

Introduction

Unfractionated heparin remains the mainstay of anticoagulation therapy during extracorporeal membrane oxygenation (ECMO) maintenance. However, its continued use in clinical practice exposes patients to the risk of developing heparin-induced thrombocytopenia (HIT).

Case Report

A 50-year-old male was diagnosed with multiple thromboses, including an intracardiac thrombi, accompanied by HIT during ECMO after cardiogenic shock related to acute myocardial infarction. The patient was successfully treated with new oral anticoagulants (NOAC), without significant complications.

Discussion

HIT during ECMO resulting in multiple thromboses is rare. To our knowledge, this is the first reported case of NOAC use in this context.

Conclusion

Although thrombocytopenia and thrombosis can occur for various reasons during ECMO maintenance, it is important to consider HIT as a potential cause. NOACs can be considered as a therapeutic option.

Keywords

extra-corporeal membrane oxygenation heparin induced thrombocytopenia new oral anticoagulants (NOACs)

Get full access to this article

View all access options for this article.

References

Arepally

. Heparin-induced thrombocytopenia. Blood 2017; 129(21): 2864–2872.

Shin

Yoon

Choi

, et al. Acute stent thrombosis and heparin induced thrombocytopenia in a patient with ST-segment elevation myocardial infarction. Korean Circ J 2012; 42(9): 646–649.

Babuin

Pengo

. Argatroban in the management of heparin-induced thrombocytopenia. Vasc Health Risk Manag 2010; 6: 813–819.

Pollak

. Heparin-induced thrombocytopenia complicating extracorporeal membrane oxygenation support: review of the literature and alternative anticoagulants. J Thromb Haemostasis 2019; 17(10): 1608–1622.

Momin

Lee

. The role of direct oral anticoagulants in the management of heparin-induced thrombocytopenia. US Pharm 2020; 45(2): 3–10.

Al-Jammali

Shatzel

. Direct oral anticoagulant therapy for heparin-induced thrombocytopenia a new alternative? J Hematol Oncol Pharm 2020; 10(3): 168–171.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB