Alterations in Pre/Post Oxygenator Flows Due to Fibrin Deposition in the CardioHelp System—A Case Report

We present a 62-year-old patient with COVID-19 pneumonia on Veno-venous (VV) Extracorporeal Membrane Oxygenation (ECMO) unique perturbations to pre and post oxygenator pressures due fibrin deposition in despite being Heparin/Bivalirudin infusion activated Partial Thromboplastin Time (aPTT) within therapeutic range of 60–80 seconds. On Day 8 ECMO support, it was noticed that flows steadily decreased unchanged RPMs. Unlike typical blood flow circuit pressure relationships, the did not correlate observed flow. The Delta Pressure (Δ P ) elevated. patient’s vitals were stable. inspection change-out, clots noted outlets. Oxygenator are usually associated increased Δ . In this scenario, blocked 1 4 outlets causing flow, pressures, drop consecutively. Due reduced elevated extensive clots. clot location CardioHelp may lead unexpected alterations. Sole reliance as marker for be misleading. Careful monitoring timely diagnosis coagulation status changes anticoagulation goals meaningfully impact outcomes.