DOI: 10.12890/2025_005493

Veno-venous ECMO support in the management of a Jehovah’s witness with severe COVID-19: a case report and literature review

Authors

  • Mohamed Qandil Department of Medicine, Medical Education, Hamad Medical Corporation (HMC), Doha, Qatar
  • Rabee Tawel Department of Medicine, Hamad General Hospital, HMC, Doha, Qatar
  • Ans Alamami Department of Medicine, Medical Intensive Care Unit, Hamad General Hospital, HMC, Doha, Qatar
  • Hani Jaouni Department of Medicine, Medical Intensive Care Unit, Hamad General Hospital, HMC, Doha, Qatar
  • Ibrahim Fawzy Hassan Department of Medicine, Medical Intensive Care Unit, Hamad General Hospital, HMC, Doha, Qatar; Department of Medicine, Weill Cornell Medical College, Doha, Qatar
  • Ayman El-Menyar Department of Medicine, Weill Cornell Medical College, Doha, Qatar; Department of Surgery, Clinical Research, Trauma and Vascular Surgery, HMC, Doha, Qatar
  • Ahmed Labib Shehatta Department of Medicine, Medical Intensive Care Unit, Hamad General Hospital, HMC, Doha, Qatar; Department of Medicine, Weill Cornell Medical College, Doha, Qatar

ashehatta@hamad.qa

Keywords

Jehovah’s Witness, COVID-19, veno-venous extracorporeal membrane oxygenation, transfusion

Abstract

Background: Severe coronavirus disease 2019 (COVID-19) infection can lead to severe acute respiratory syndrome for which extracorporeal membrane oxygenation (ECMO) could be used in selected cases. Most Jehovah’s witnesses (JWs) do not accept transfusion of blood and/or blood products. The use of ECMO for the management of JWs during the pandemic was challenging.
Case report: We present a case of a JW with severe COVID-19 infection and multiple organ failure necessitating ECMO support for 20 days. We discuss the management challenges in patients who do not accept blood transfusions. A significant drop in the patient’s haemoglobin and platelet count was observed throughout ECMO duration. An anti-coagulation-free ECMO circuit was maintained, and we did not observe any major circuit or patient complications.
Conclusion: Management strategies to minimize blood loss, avoid bleeding, augment haemoglobin production, maintain ECMO circuit integrity without systemic anticoagulation, and reduce blood loss during ECMO decannulation are helpful in the management of JW followers on ECMO. We recommend treatment in such a situation at experienced centres with the involvement of a haematologist within an interprofessional team.

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References

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Published

2025-05-21

Issue

Vol. 12 No. 6 (2025)

Categories

How to Cite

1.
Qandil M, Tawel R, Alamami A, Jaouni H, Hassan IF, El-Menyar A, et al. Veno-venous ECMO support in the management of a Jehovah’s witness with severe COVID-19: a case report and literature review. EJCRIM [Internet]. 2025 May 21 [cited 2026 Nov. 3];12(6). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5493

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