Is therapeutic hypothermia during neonatal extracorporeal membrane oxygenation associated with intracranial hemorrhage?

Journal Article (Journal Article)

INTRODUCTION: The use of therapeutic hypothermia during neonatal extracorporeal membrane oxygenation (ECMO) as a neurologic protective strategy has gained interest among clinicians despite limited data. Our objective is to describe the relationship between the use of therapeutic hypothermia during neonatal ECMO and complications, mortality and functional status among survivors. METHODS: Secondary analysis of data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. Data were collected prospectively from 267 neonates (<30 days) undergoing ECMO at eight clinical sites. Twenty neonates received therapeutic hypothermia. RESULTS: Neonates receiving therapeutic hypothermia were more likely to have intracranial hemorrhage during the first seven days of ECMO than were non-hypothermic neonates (40.0% vs 15.8%, p=0.012). No differences were observed between groups for hospital mortality or functional status at hospital discharge among survivors. Variables independently associated with intracranial hemorrhage in the first seven days of ECMO included therapeutic hypothermia, gestational age at birth, age at initiation of ECMO, fibrinogen concentration and mode of ECMO. CONCLUSION: Therapeutic hypothermia during neonatal ECMO appears to be associated with intracranial hemorrhage.

Full Text

Duke Authors

Cited Authors

  • Cashen, K; Reeder, RW; Shanti, C; Dalton, HJ; Dean, JM; Meert, KL; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN),

Published Date

  • July 2018

Published In

Volume / Issue

  • 33 / 5

Start / End Page

  • 354 - 362

PubMed ID

  • 29228894

Pubmed Central ID

  • PMC6091861

Electronic International Standard Serial Number (EISSN)

  • 1477-111X

Digital Object Identifier (DOI)

  • 10.1177/0267659117747693

Language

  • eng

Conference Location

  • England