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Computed tomography of a 63-year-old man on the day of admission for respiratory failure due to COVID-19 pneumonia. The scan of the chest shows a crazy paving pattern.
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On admission, computed tomography of the chest showed a crazy paving pattern (Fig. 1).
Timeline of clinical features and laboratory findings in a 63-year-old man with respiratory failure due to COVID-19 pneumonia. Nafamostat was discontinued after 4 days (black arrow) due to hyperkalemia and hemothorax. ECMO, extracorporeal membrane oxygenation.
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Because V-V ECMO could not oxygenate his blood, replacement of the ECMO membrane was required 4 days after the initial V-V ECMO insertion (Fig. 2, first black triangle). Blood tests showed that fibrinogen had decreased while D-dimer had not increased with the combination therapy (Fig. 2). On day 15, the patient developed hyperkalemia (potassium, 6.5 mEq/L) and hemothorax; thus, nafamostat infusion was stopped (Fig. 2, black arrow). However, ECMO membrane exchange was needed on days 17 and 28 (Fig. 2).