Amerikanische Gesellschaft für Hirudotherapie

Nitric oxide in the ECMO circuit as a treatment option for heparin-induced thrombocytopenia: A case report

Case report published in Perfusion (2026)

Zuletzt aktualisiert: June 18, 2026Geprüft von: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportArzneimittelentwicklungKlinische StudienJoelsons D et al. · Perfusion, 2026

Abstract

IntroductionExtracorporeal membrane oxygenation (ECMO) involves the use of a synthetic circuit, which initiates a complex interplay of inflammatory and pro-coagulant responses. This intricate, self-reinforcing process results in a prothrombotic state, predisposing patients to arterial, venous, or oxygenator thrombosis. Unfractionated heparin is the standard anticoagulant chosen in ECMO patients to prevent such complications.Case ReportIn this case report our patient presented heparin-induced thrombocytopenia (HIT), a possible complication.DiscussionAlternative strategies such as bivalirudin and argatroban are possible options but due the unavailability of those medications at our institution, nitric oxide (NO) via sweep-gas flow was deemed a reasonable alternative considering it's anti-aggregant effect.ConclusionThis case report details the use of NO as a possible alternative anticoagulant strategy in a patient with ECMO complicated by HIT.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article

Zusammenfassung

Reports use of sweep-gas nitric oxide as an unconventional anti-aggregant alternative on the ECMO circuit when bivalirudin and argatroban were unavailable to manage HIT during ECMO.

Warum dies für die Hirudotherapie relevant ist

This case report describes the use of nitric oxide (NO) via sweep-gas flow as an alternative anticoagulant strategy in an ECMO patient who developed heparin-induced thrombocytopenia (HIT), when bivalirudin and argatroban were unavailable at the institution. The abstract notes NO's anti-aggregant effect as the rationale for its use and details no other management options employed. The article has no relevance to ASH's domain: the abstract does not mention hirudin, lepirudin, leeches, or any leech-derived therapy, and the focus is entirely on NO as a novel ECMO anticoagulation workaround. CAVEAT: This is a single case report with no leech-related content and no direct connection to hirudotherapy or the leech secretome.

Zitation

Nitric oxide in the ECMO circuit as a treatment option for heparin-induced thrombocytopenia: A case report.

Joelsons D et al. · Perfusion, 2026

DOI

Verwandter klinischer Kontext

Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist

Drug PipelineDrug DevelopmentDirect Thrombin InhibitorsClinical EvidenceClinical ApplicationsHirudinAnticoagulation CompoundsBivalirudinHemostasisOtolaryngology

Zur ASH-Bibliothek hinzugefügt: May 27, 2026 · Letzte Aktualisierung der Website: June 18, 2026

Diese Website stellt Bildungsinformationen bereit und ist weder eine medizinische Beratung noch eine Diagnose oder Behandlungsempfehlung. Die medizinische Blutegeltherapie ist mit klinisch relevanten Risiken verbunden und sollte ausschließlich von qualifizierten Klinikerinnen und Klinikern unter institutionell genehmigten Protokollen durchgeführt werden. Die FDA-510(k)-Zulassung für medizinische Blutegel ist auf bestimmte Indikationen beschränkt; experimentelle und Off-Label-Diskussionen werden entsprechend gekennzeichnet. Für patientenspezifische Beratung wenden Sie sich an eine qualifizierte Gesundheitsfachkraft.