Bleeding Complications and Mortality in Neonates Receiving Therapeutic Hypothermia and Extracorporeal Membrane Oxygenation

Am J Perinatol. 2018 Feb;35(3):271-276. doi: 10.1055/s-0037-1607197. Epub 2017 Sep 25.

Abstract

Objective: The objective of this study was to compare complications and mortality in neonates with hypoxic ischemic encephalopathy (HIE) on extracorporeal membrane oxygenation (ECMO) who did and did not receive therapeutic hypothermia (TH).

Study design: The Extracorporeal Life Support Organization registry was queried from 2005 to 2013 to identified infants with HIE. Infants ≤30 days of age with HIE on respiratory ECMO were included. Fisher's exact test and the Wilcoxon's rank-sum test were used to compare neonates with and without TH. Logistic regression was used to examine the association of TH with complications and mortality.

Results: There were no difference between neonates with HIE who did (n = 78) and did not (n = 109) receive TH in demographics, severity of illness, complications, and mortality (p = 0.21).

Conclusion: No differences in complications or mortality in neonates with HIE and respiratory ECMO were observed between those who did and did not receive TH. We suggest that for neonates requiring respiratory ECMO who also have HIE, TH is not contraindicated.

MeSH terms

  • Extracorporeal Membrane Oxygenation / adverse effects*
  • Extracorporeal Membrane Oxygenation / methods
  • Female
  • Hemorrhage / etiology*
  • Humans
  • Hypothermia, Induced / adverse effects*
  • Hypothermia, Induced / methods
  • Hypoxia-Ischemia, Brain / mortality*
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Logistic Models
  • Male
  • Registries
  • Texas / epidemiology