NDLI: Severe Thrombotic and Bleeding Complications in a Baby with Heterozygous Factor V Leiden and Acquired von Willebrand Disease on ECMO

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Severe Thrombotic and Bleeding Complications in a Baby with Heterozygous Factor V Leiden and Acquired von Willebrand Disease on ECMO

Content Provider	PubMed Central
Author	Bilen, Ozlem Loftis, Laura Teruya, Jun
Copyright Year	2011
Abstract	We aim to present the case of a 5-week-old girl with severe respiratory failure placed on veno-venous extracorporeal membrane oxygenation (ECMO) that was then switched to veno-arterial ECMO. She required up to 60 units/kg/hr of heparin to keep her heparin level within the target range at .3–.7 units/mL. During the ECMO course, substantial thrombus formation was observed within the venous site of the ECMO cannula, which led to two circuit changes on ECMO day 9 and day 20. On ECMO day 15, she was noticed to have purpuric lesions on her chest and her right hand with no obvious arterial or venous clot detected by Doppler ultrasound. She was also noted to have remarkable hemolysis as the plasma free hemoglobin levels were substantially elevated up to 700 mg/dL. She was noted to have continuous oozing from the catheter insertion sites despite adequate underlying coagulation status. Her subsequent platelet function analysis, the thromboelastography, and thromboelastography platelet mapping suggested substantial platelet dysfunction. Her von Willebrand panel revealed absence of high molecular weight multimers. Further coagulation workup was prompted which revealed heterozygosity for factor V Leiden. The patient developed severe pulmonary hemorrhages and ECMO was discontinued on day 40.
Starting Page	64
File Format	PDF
ISSN	00221058
Journal	The Journal of Extra-corporeal Technology
Issue Number	2
Volume Number	43
Language	English
Publisher	American Society of ExtraCorporeal Technology
Publisher Date	2011-06-01
Access Restriction	Open
Rights Holder	American Society of ExtraCorporeal Technology
Subject Keyword	Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Health Professions Cardiology and Cardiovascular Medicine

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