Clinical Research Directory

Inclusion Criteria: 1. Age \< 6 year at ECMO cannulation 2. Veno-arterial (VA) mode of ECMO 3. First ECMO run during the index hospitalization Exclusion Criteria: 1. Gestationally-corrected age \< 37 weeks at the time of ECMO cannulation 2. Veno-venous (VV) mode of ECMO 3. Patients initially started on VV-ECMO and then transitioned to VA ECMO \> 18 hours after ECMO cannulation 4. ECMO used for procedural support (ECMO deployed and decannulated in procedural area with no ICU ECMO care) or ECMO duration expected to be \< 24 h 5. Limitation of care in place or being discussed 6. Congenital bleeding disorders 7. Hemoglobinopathies 8. Primary Residence outside country of enrollment 9. Concurrent participation in a separate interventional trial that has potential to impact neurodevelopment status of patient. (note that observational non-interventional studies do not qualify the patient for exclusion). This includes a patient already enrolled in TITRE 10. Lack of access to medical records required for calculation of pre-ECMO pSOFA score due to cannulation for ECMO at a non-trial center. 11. Randomization not possible within 36 h following ECMO cannulation (e.g., due to staffing or delays related to communication with participant family) 12. Planned transition to ventricular assist device (VAD) within 48 hours of commencing ECMO. 13. Clinically documented indication for a Red Blood Cell transfusion threshold that differs from the center-specific transfusion threshold (e.g., oncological treatment that limits donor exposure).