Thrombophilia in Pediatric Patients with Multisystem Inflammatory Syndrome in Children Secondary to Coronavirus Disease 2019 Supported on Extracorporeal Membrane Oxygenation.
ASAIO J
; 67(1): 7-11, 2021 01 01.
Article
in English
| MEDLINE | ID: covidwho-990906
ABSTRACT
Coronavirus disease 2019 (COVID-19) in adults has been associated with thrombosis. Multisystem inflammatory syndrome in children (MIS-C) with COVID-19 case series have reported high fibrinogen levels, but it is not known whether this causes thrombophilia. We report two patients needing extracorporeal membrane oxygenation (ECMO) who both suffered thrombotic complications. We retrospectively reviewed patients with MIS-C needing ECMO support admitted to a single Paediatric and Cardiac Intensive Care Unit within a regional center for MIS-C in South East England. Two children required ECMO for cardiovascular support. Both developed thrombotic events despite receiving heparin infusions at dosing higher than the interquartile range for our ECMO population. Case 1 developed a right anterior and middle cerebral artery infarct, which led to his death. Case 2 had a right atrial thrombus, which resolved without complication. When compared with patients undergoing ECMO in the same institution in pre-MIS-C era, fibrinogen levels were consistently higher before and during ECMO therapy. MIS-C patients presenting with hyperfibrinogenemia are likely to have a propensity toward thrombotic complications; this must be considered when optimizing the anticoagulation strategy on ECMO.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Systemic Inflammatory Response Syndrome
/
Thrombophilia
/
COVID-19
Type of study:
Case report
/
Observational study
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Language:
English
Journal:
ASAIO J
Journal subject:
Transplantation
Year:
2021
Document Type:
Article
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