Thromboelastography-guided management of coagulopathy in neonates with congenital diaphragmatic hernia supported by extracorporeal membrane oxygenation

Standardized TEG-guided anticoagulation protocols for CDH neonates on ECMO improved blood product utilization and reduced bleeding complications. Post-2015 protocol implementation showed increased platelet use for low MA, decreased cryoprecipitate use, and an 18% hemothorax rate versus 54% pre-protocol.