Paediatric anaesthesia & critical care
Bivalirudin use and Outcomes in Neonates With Congenital Diaphragmatic Hernia Managed With Extracorporeal Life Support
Main finding · In-hospital mortalityResult — go to the resultAdjusted odds ratio 1.08 95% CI 0.42–2.82Authors' conclusion
Among neonates with CDH supported with ECMO, bivalirudin use increased substantially over the study period and was associated with higher hospital charges but not with improved survival or reduced ECMO-related morbidity compared with unfractionated heparin.
Study context
- Population
- Neonates with congenital diaphragmatic hernia supported with extracorporeal membrane oxygenation (ECMO), 48 US children's hospitals, 2016–2023820 in final cohort
- Participants
- 1,049 neonates
- Exposure
- Bivalirudin vs unfractionated heparin for ECMO anticoagulation
- Outcome
- In-hospital mortality
Methodological detailsmulticentre, multivariable logistic regression
- Multicentre
- Multivariable logistic regression
Main finding
As reported in the abstract
Adjusted odds ratio
1.08
95% CI 0.42–2.82
P = 0.87
Bivalirudin vs Heparin
aOR 1.08 (95% CI 0.42–2.82); P = 0.87
- Overall in-hospital deaths in final cohort (48.5% mortality)
- 398
Observational data: associations, not effects.
Secondary outcomes
Median $
| Outcome | Bivalirudin | Heparin | P value |
|---|---|---|---|
| Hospital charges | 876,054 (IQR $652,735 - $1,366,728) | 577,326 (IQR $384,468 - $871,769) | P < 0.0001 |
Bivalirudin utilization over time
- Bivalirudin use in 2016
- 9.6%
- Bivalirudin use in 2023
- 48.0%
Safety
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Bleeding | 1.43 (0.54–3.82) | P = 0.47 | |
| Thrombosis | 1.88 (0.65–5.41) | P = 0.24 | |
| Neurologic complications | 2.00 (0.81–4.91) | P = 0.13 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
Bivalirudin use and Outcomes in Neonates With Congenital Diaphragmatic Hernia Managed With Extracorporeal Life Support. Ann Surg. Published 22 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →