Episode notes
In this session from the 12th Annual Update Course in Pediatric Surgery, Drs. Rebecca Stark and Steven Lee from Seattle Children’s Hospital walk through the timing, technique, and evolving protocols for performing ECMO and surgical repair in cases of severe congenital diaphragmatic hernia (CDH).
Key Highlights:
- VA ECMO with bivalirudin: The presenters advocate for bivalirudin as a preferred anticoagulant over heparin due to its short half-life, predictable response, and ease of control—making it ideal for ECMO patients requiring surgery.
- Dilute thrombin time for monitoring: They highlight a lab-friendly technique for monitoring bivalirudin using dilute thrombin time—5x more specific and sensitive than PTT and easily implementable in any lab.
Keywords
pediatric surgerycdhcongenital diaphragmatic herniapediatricsome4pedsurgECMOneonatesbivalirudinVA ECMO early repair severe congenital diaphragmatic hernia (CDH)edemadilute thrombin