Plasma exchange on venovenous extracorporeal membrane oxygenation with bivalirudin anticoagulation.

A pediatric patient requiring venovenous (VV) extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation developed heparin-induced thrombocytopenia. Unfractionated heparin was discontinued, and a bivalirudin infusion was started. During the lung transplant evaluation, he was found to have allosensitization, requiring treatment with plasma exchange along with pulse methylprednisolone, rituximab, bortezomib, and pooled immunoglobulin infusion.

Improving the management and delivery of bedside patent ductus arteriosus ligation.

Some surgical procedures can be performed more safely outside the OR. One procedure commonly performed within the neonatal intensive care unit (NICU) is patent ductus arteriosus (PDA) ligation. Staff members at one tertiary care facility assessed current management and delivery of bedside PDA ligation surgery and identified several problem areas, including communication issues regarding patient and unit readiness, design of instrument sets, and organization and transportation of surgical supplies.