Platelet dysfunction during pediatric cardiac ECMO

Pediatric extracorporeal membrane oxygenation (ECMO) is used for respiratory and cardiac failure refractory to conventional treatment. ECMO has been increasingly utilized for pediatric cardiac patients. Despite improved mortality, complications during and after ECMO are high and bleeding may be life threatening. Pediatric cardiac patients are at high risk for bleeding due to anticoagulation, surgery, and acquired platelet dysfunction. In this review, we focus on the many mechanisms contributing to platelet dysfunction, available monitoring of platelet function, what is known about platelet count and transfusion, treatment of bleeding, and future steps needed to improve our care for this patient population.