ECMO Hemostatic Transfusions in Children

Inclusion Criteria: * Critically ill children (0 to \<18 years of age) * Admitted to a participating pediatric, neonatal, or cardiac intensive care unite (PICU/NICU/CICU) * On extracorporeal Membrane Oxygenation (ECMO) * Who have either no bleeding or minimal bleeding, within 24 hours of cannulation. Minimal bleeding is defined as: * streaks of blood in endotracheal tube or during suctioning only * streaks of blood in nasogastric tube * macroscopic hematuria * subcutaneous bleeding (including hematoma and petechiae) \< 5 cm in diameter * quantifiable bleeding \< 1mL/kg/hr (e.g., chest tube) * bloody dressings required to be changed no more often than each 6hr, or weighing no more than 1mL/kg/hr if weighed, due to slow saturation Exclusion Criteria: * Post-conception age \< 37 weeks at time of screening * Underlying oncologic diagnosis (defined as receipt of chemotherapy or radiation in the last six months) or recipient of bone marrow transplant in the last year * Congenital bleeding disorder * Pregnant or admitted post-partum * Decision to withdraw or withhold some critical care or interventions * Known objection to blood transfusions * On ECMO for \> 24 hours at time of enrollment