ArticleJournal of atherosclerosis and thrombosis2021
Management of a COVID-19 Patient during ECMO: Paying Attention to Acquired von Willebrand Syndrome.
Article in Journal of atherosclerosis and thrombosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Heparin Resistance in Patients Receiving Extracorporeal Membrane Oxygenation: A Review.Journal of clinical medicine · 2024Review
- Excessive cleavage of von Willebrand factor multimers by ADAMTS13 may predict the progression of transplant-associated thrombotic microangiopathy.Research and practice in thrombosis and haemostasis · 2024Article
- COVID-19 increases extracorporeal coagulation during hemodialysis associated with upregulation of vWF/FBLN5 signaling in patients with severe/critical symptoms.BMC infectious diseases · 2024Article
- Shear-induced acquired von Willebrand syndrome: an accomplice of bleeding events in adults on extracorporeal membrane oxygenation support.Frontiers in cardiovascular medicine · 2023Review
- Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Observational
- COVID-19 microthrombosis: unusually large VWF multimers are a platform for activation of the alternative complement pathway under cytokine storm.International journal of hematology · 2022Review
- Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination.International journal of molecular sciences · 2022Review
- Therapeutic Strategies for Disseminated Intravascular Coagulation Associated with Aortic Aneurysm.International journal of molecular sciences · 2022Review
- Elevated TAT in COVID-19 Patients with Normal D-Dimer as a Predictor of Severe Respiratory Failure: A Retrospective Analysis of 797 Patients.Journal of clinical medicine · 2021Article
- Spontaneous Muscle Hematoma in Japanese Patients with Severe COVID-19 Treated with Unfractionated Heparin: Two Case Reports.Internal medicine (Tokyo, Japan) · 2021Article
- Emergency lower gastrointestinal endoscopy performed safely in a COVID-19 patient on extracorporeal membrane oxygenation (ECMO) with hemorrhagic shock.Clinical journal of gastroenterology · 2021Article
- Article
- Etiology and Management of Bleeding during ECMO in a COVID-19 Patient.Journal of atherosclerosis and thrombosis · 2021Article
- COVID-19-Related Thrombosis in Japan: Final Report of a Questionnaire-Based Survey in 2020.Journal of atherosclerosis and thrombosis · 2021Article
- Response to "Etiology and Management of Bleeding during ECMO in a COVID-19 Patient".Journal of atherosclerosis and thrombosis · 2021Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients with severe COVID-19 often experience complications including coagulopathy and fatal thrombosis. COVID-19 pneumonia sometimes leads to acute respiratory distress syndrome, requiring extracorporeal membrane oxygenation (ECMO), during which thrombosis and bleeding are major causes of death. Anticoagulation such as heparin is essential for COVID-19 patients on ECMO; however, bleeding might be caused by not only heparin, but also acquired von Willebrand syndrome (AVWS). To date, no study has examined ECMO-related bleeding and AVWS in COVID-19 patients.We report a COVID-19 patient who experienced bleeding from AVWS in addition to disseminated intravascular coagulation (DIC) during ECMO. The level of high-molecular weight VWF multimers decreased during ECMO therapy, and these findings promptly improved after discontinuation of ECMO. Plasma levels of VWF antigen were extremely high, probably due to endothelial cell damage caused by COVID-19. On the other hand, plasma levels of ADAMTS13 activity were moderately reduced, to 20-30% of normal. The patient was successfully treated with cryoprecipitate in bleeding during ECMO without a reduction in heparin, which might have induced thromboembolism. Bleeding found in this patient might be caused by AVWS and DIC.Severe COVID-19 patients are in a thrombotic state and need to receive anticoagulant therapy. However, once they receive ECMO therapy, bleeding symptoms could be observed. In such cases, physicians should think of AVWS in addition to the side effect of heparin and DIC.
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