Successful ECMO treatment in patients with cerebral hemorrhage and PROC gene mutation associated with VTE: a case report

TL;DR

A patient with cerebral hemorrhage and a PROC gene mutation was successfully treated with VA-ECMO, highlighting challenges in managing anticoagulation and bleeding risks.

Contribution

This case report presents a rare combination of cerebral hemorrhage, PROC gene mutation, and successful VA-ECMO treatment.

Findings

VA-ECMO therapy was successfully used for 20 days in a patient with severe pulmonary embolism.

A mutation in the PROC gene was identified during treatment, complicating anticoagulation management.

The patient was successfully weaned off ECMO and discharged, offering insights for similar clinical cases.

Abstract

In this report, we report a case of a middle-aged male, admitted to the ICU with cerebral hemorrhage resulting from a severe high-altitude fall. The patient encountered significant challenges in oxygenation index correction, attributed to extensive embolism in both the primary and branch pulmonary arteries. Consequently, the patient underwent an immediate initiation of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) therapy, persisting for 20 days. During this treatment period, a mutation in the protein C (PROC) gene was identified. The medical team meticulously navigated the delicate balance between anticoagulation and bleeding risks. Eventually, the patient was successfully weaned off VA-ECMO and subsequently discharged. This report aims to delve into the etiology and therapeutic approaches of this uncommon case, with the intention of offering insightful reference for managing similar clinical scenarios in the future.

The online version contains supplementary material available at 10.1186/s12959-024-00601-y.

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