Open AccessUse of Thromboelastogram in Venovenous Extracorporeal Membrane Oxygenation for a Patient with Pulmonary Hemorrhage due to Microscopic Polyangiitis
Author(s) -
Chak-Kwan Tong,
Jiaqi Jin,
Qian Du
Publication year - 2019
Publication title -
case reports in critical care
Language(s) - English
Resource type - Journals
eISSN - 2090-6439
pISSN - 2090-6420
DOI - 10.1155/2019/7241264
Subject(s) - extracorporeal membrane oxygenation , medicine , partial thromboplastin time , activated clotting time , heparin , thrombus , respiratory failure , coagulopathy , anesthesia , intensive care medicine , cardiology , surgery , coagulation
Systemic heparinisation is required for extracorporeal membrane oxygenation therapy, to prevent clotting of circuit and formation of thrombus in patient. Activated clotting time (ACT) or activated partial thromboplastin time (aPTT) has been the mainstay of monitoring of heparin dose. Thromboelastogram (TEG) is increasingly being used again in recent years with the advancement in technology. Its clinical usefulness in the monitoring of anticoagulation of ECMO therapy is demonstrated in the case presented. Our patient suffered from severe hemoptysis due to active microscopic polyangiitis and respiratory failure. Heparin infusion was given at the initiation of ECMO support without further aggravation of hemoptysis. Dose of heparin was adjusted successfully with the integration of the clotting profile and TEG results.