Inclusion criteria
- Age 0 to 16 years
- Body weight of 3-80 kilograms
- VA-ECMO use for primary cardiac failure using the Cardiohelp system
- First ECMO run during any hospitalization
- Written informed consent from the parent or LAR (legally authorized representative)
Exclusion criteria
A child is not eligible to participate because of any of the following circumstances:
- Gestationally-corrected age <37 weeks
- Bleeding or coagulopathy that is a contraindication to anticoagulation
- Irreversible renal, hepatic, or lung failure
- Stroke or uncertain neurological status within the past 30 days
- Severely malnourished
- Use of an ECMO system other than the Cardiohelp
- VV-ECMO or ECMO for primary respiratory failure
- Goals of patient to focus on comfort measures only
- Failure to separate from cardiopulmonary bypass
- Allergy or contraindication to receiving heparin or bivalirudin as a primary anticoagulant on ECMO