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CARDIOVASCULAR ANESTHESIOLOGY

Extracorporeal Membrane Oxygenation with Danaparoid Sodium After Massive Pulmonary Embolism

Christian Bauer, MD^*, Zuzana Vichova, MD^*, Patrick Ffrench, MD^*, Christiane Hercule, MD^*, Olivier Jegaden, PhD^*, Olivier Bastien, PhD^*, and Jean-Jacques Lehot, PhD^*

From *Université Claude Bernard Lyon 1, France; and Hemostasis Laboratory, Department of Cardiovascular Surgery, and Anesthesiology and Intensive Care Unit, Hospices Civils de Lyon, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Bron, France.

Address correspondence to Christian Bauer, MD, Hospices Civils Lyon, Hopital Cardiovasculaire et Pneumologique Louis Pradel, Anesthesiology and Intensive Care Unit, Bron, F-69677, France. Address e-mail to christian.bauer{at}chu-lyon.fr.

Abstract

During extracorporeal membrane oxygenation, anticoagulation therapy is usually achieved with unfractionated heparin. We report on an extracorporeal membrane oxygenation with danaparoid sodium for a patient with severe respiratory failure due to massive pulmonary embolism and suspected type 2 heparin-induced thrombocytopenia. Danaparoid, a low molecular weight heparinoid, is an alternative to heparin for patients who develop type 2 heparin-induced thrombocytopenia. Danaparoid was given at 400 IU/h with an objective of antifactor Xa activity of 0.6–0.8 U/mL, which was monitored twice a day. No excessive bleeding or clotting of the circuit was noted. The patient was weaned from extracorporeal membrane oxygenation after 9 days of treatment.