Prolonged Venovenous Extracorporeal Membrane Oxygenation Without Anticoagulation: A Case of Goodpasture Syndrome-Related Pulmonary Haemorrhage

We present a 16-year-old male with severe acute respiratory and renal failure as a result of Goodpasture syndrome, requiring venovenous extracorporeal membrane oxygenation (VV-ECMO) for pulmonary hemorrhage. The patient received no systemic anticoagulation for 25 of 26 ECMOdays (20 days consecutively) and suffered no coagulation-related adverse events. The patient had a subtherapeutic anticoagulation profile according to recommended ECMO guidelines during most of this time. The patient made a full recovery without respiratory compromise, ECMO circuit failure, thrombotic events or the need for ongoing haemodialysis.