Advertisement

Topics

Intrahepatic Hematoma and Pulmonary Embolism in a Young Woman with Oral Contraceptives Complicated by Type II Heparin Induced Thrombocytopenia Requiring ECMO-Therapy: a Case Report.

08:00 EDT 1st April 2019 | BioPortfolio

Summary of "Intrahepatic Hematoma and Pulmonary Embolism in a Young Woman with Oral Contraceptives Complicated by Type II Heparin Induced Thrombocytopenia Requiring ECMO-Therapy: a Case Report."

A 46-year-old woman on oral contraceptives developed an intrahepatic hematoma due to a benign hepatic tumor. As an incidental finding, a computed tomography showed a pulmonary embolism. Unfractionated heparin was given in a prophylactic dosing in an attempt to balance the risk of further intrahepatic bleeding with that of thrombosis. Ten days later, the patient developed a second pulmonary embolism along with acute right heart failure requiring cardiopulmonary resuscitation. As a sufficient circulation and oxygenation could not be reestablished, a veno-arterial extracorporeal membrane oxygenation (ECMO) was installed. An ELISA-Test, detecting PF4-Heparin associated antibodies, resulted in a positive result for a type II heparin induced thrombocytopenia even in the absence of thrombocytopenia. After hemodynamic and pulmonary stabilization, six days after ECMO-support the cannula was scheduled to be removed. On removal of the venous cannula the patient developed another massive pulmonary embolism with cardiac arrest which led to immediate reinstallation of va-ECMO. Under therapeutic anticoagulation using argatroban the ECMO support continued until the patient was on day 17 successfully weaned.

Affiliation

Journal Details

This article was published in the following journal.

Name: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
ISSN: 1439-1074
Pages: 295-300

Links

DeepDyve research library

PubMed Articles [10838 Associated PubMed Articles listed on BioPortfolio]

Surgical treatment for pulmonary embolization of a right atrial myxoma.

We report the case of a woman with pulmonary embolism due to a cardiac mass. Echocardiography, CT scan and cardiac magnetic resonance raised the suspicion of right atrial myxoma and confirmed the pres...

Syncope as the initial presentation of pulmonary embolism in a young adult with testicular tumor: A case report and literature review.

Venous thrombus embolism (VTE) includes deep-vein thrombosis (DVT) and pulmonary embolism (PE) which may be an initial symptom for patients with cancer. PE has diverse clinical manifestations and is a...

Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism.

Pulmonary embolism is one of the leading causes of maternal death in the Western world. Because of the low specificity and sensitivity of the d-dimer test, all pregnant women with suspected pulmonary ...

A low end-tidal CO/arterial CO ratio during cardiopulmonary resuscitation suggests pulmonary embolism.

Identifying reversible causes of cardiac arrest is challenging. The diagnosis of pulmonary embolism is often missed. Pulmonary embolism increases alveolar dead space resulting in low end-tidal CO (EtC...

Prescription patterns of direct oral anticoagulants in pulmonary embolism: A prospective multicenter French registry.

Data regarding the use of direct oral anticoagulants (DOACs) for the treatment of acute pulmonary embolism (PE) are sparse. We conducted a prospective multicentre registry study to describe patterns o...

Clinical Trials [10188 Associated Clinical Trials listed on BioPortfolio]

Tinzaparin in the Treatment of the Acute Pulmonary Embolism

The purpose of this study is to evaluate the feasibility of the long-term treatment of pulmonary embolism with tinzaparin compared to oral anticoagulants.

PEITHO Pulmonary Embolism Thrombolysis Study

Heparin is the reference therapy for most patients with pulmonary embolism. Some patients with sub-massive pulmonary embolism defined by normal blood pressure and dysfunction of the right ...

Arixtra PE Study- Outpatient Management of Stable Acute Pulmonary Embolism: Once Daily Subcutaneous Fondaparinux

To assess the safety and efficacy of outpatient treatment using fondaparinux and oral Vit K antagonist, warfarin (Coumadin) in patients with stable acute pulmonary embolus (APE)when initia...

Pulmonary Rehabilitation to Improve Physical Capacity After Pulmonary Embolism

This project aims to evaluate a rehabilitation program as treatment and uncover potential pathophysiological mechanisms of a newly identified chronic condition named "Post Pulmonary Emboli...

Study of Diagnosis and Pathophysiology of Pulmonary Embolism (APE 1 Trial)

The purpose of this study is to - investigate which method and criterion for diagnosing pulmonary embolism is the best and - determine the relationship between blood ves...

Medical and Biotech [MESH] Definitions

Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM.

Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.

An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.

Impairment of bile flow due to injury to the HEPATOCYTES; BILE CANALICULI; or the intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC).

A rare epidural hematoma in the spinal epidural space, usually due to a vascular malformation (CENTRAL NERVOUS SYSTEM VASCULAR MALFORMATIONS) or TRAUMA. Spontaneous spinal epidural hematoma is a neurologic emergency due to a rapidly evolving compressive MYELOPATHY.

Advertisement
Quick Search
Advertisement
Advertisement

 


DeepDyve research library

Relevant Topics

Hepatology
Hepatology is the study of liver, gallbladder, biliary tree, and pancreas, and diseases associated with them. This includes viral hepatitis, alcohol damage, cirrhosis and cancer. As modern lifestyles change, with alcoholism and cancer becoming more promi...

Cardiology
Cardiology is a specialty of internal medicine.  Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...


Searches Linking to this Article