Extracorporeal Membrane Oxygenation Bridging to Lung Transplant Complicated by Heparin-Induced Thrombocytopenia

作者：Dolch Michael E^*; Frey Lorenz; Hatz Rudolf; Ueberfuhr Peter A; Beiras Fernandez Andres; Behr Juergen; Irlbeck Michael

来源：Experimental and Clinical Transplantation, 2010, 8(4): 329-332.

• Argatroban
• Acute respiratory distress syndrome
• Lung assist
• Anticoagulation
• Complications

In patients with acute respiratory failure and life-threatening impairment of pulmonary gas exchange, venovenous extracorporeal membrane oxygenation offers further therapeutic options. During extracorporeal membrane oxygenation treatment, systemic anticoagulation is usually achieved by heparin administration, which exposes patients to the risk of heparin-induced thrombocytopenia type II. We present a patient with acute respiratory distress syndrome on venovenous extracorporeal membrane oxygenation who experienced heparin-induced thrombocytopenia type II and in whom anticoagulation was continued with argatroban. Because respiratory failure did not resolve, the patient was bridged to lung transplant with extracorporeal membrane oxygenation. Argatroban anticoagulation was safely used until lung transplant (on day 114 after extracorporeal membrane oxygenation initiation) and after transplant in the presence of hepatic failure.

• 出版日期2010-12