Regional anticoagulation with heparin of an extracorporeal CO2 removal circuit: a case report.
BACKGROUND
Extracorporeal carbon dioxide removal is an increasingly used respiratory support technique. As is true of all extracorporeal techniques, extracorporeal carbon dioxide removal needs proper anticoagulation. We report a case of a patient at risk of bleeding complications who was treated with extracorporeal carbon dioxide removal and anticoagulated with a regional technique.


CASE PRESENTATION
A 56-year-old Caucasian man with a history of chronic obstructive pulmonary disease exacerbation required extracorporeal carbon dioxide removal for severe hypercapnia and acidosis despite mechanical ventilation. The extracorporeal circuit was anticoagulated using a regional heparin technique to limit the patient's risk of bleeding due to a low platelet count. The patient underwent 96 h of effective extracorporeal carbon dioxide removal without any adverse events. He was successfully weaned from extracorporeal carbon dioxide removal. During the treatment, no bleeding complications or unexpected circuit clotting was observed.


CONCLUSIONS
The use of regional heparin anticoagulation technique seems to be feasible and safe during extracorporeal carbon dioxide removal.
['Tramarin|Jacopo|J|', 'Cortegiani|Andrea|A|', 'Gregoretti|Cesare|C|', 'Vitale|Filippo|F|', 'Palmeri|Cesira|C|', 'Iozzo|Pasquale|P|', 'Forfori|Francesco|F|', 'Giarratano|Antonino|A|']
D000925:Anticoagulants D002245:Carbon Dioxide D018450:Disease Progression D005112:Extracorporeal Circulation D015199:Extracorporeal Membrane Oxygenation D006493:Heparin D006801:Humans D008297:Male D008875:Middle Aged D029424:Pulmonary Disease, Chronic Obstructive D012121:Respiration, Artificial D016896:Treatment Outcome
Extracorporeal CO2 removal Continuous venovenous filtration Heparin regional anticoagulation