Bivalirudin in pediatric extracorporeal membrane oxygenation.

Abstract in brief

• The review highlights that bivalirudin could be a good alternative anticoagulant for children on ECMO bypass who do not respond well to heparin, potentially reducing blood transfusions and costs while maintaining similar clinical outcomes.
• The main method for monitoring bivalirudin use is the activated partial thromboplastin time (aPTT), but it has limitations; other tests like dilute thrombin time (dTT) and viscoelastic assays show promise but need further research.
• While current evidence suggests bivalirudin is safe and effective for pediatric ECMO patients failing heparin, larger and more comprehensive studies are necessary to confirm these findings and ensure its widespread use.