A Pilot investigation of mild hypothermia in neonates receiving extracorporeal membrane oxygenation (ECMO)

• Published in: The Journal of pediatrics Vol. 144; no. 3; pp. 301 - 308
• Main Authors: Horan, Marie, Ichiba, Shingo, Firmin, Richard K, Killer, Hilliary M, Edwards, David, Azzopardi, Denis, Hodge, Rachel, Kotecha, Sailesh, Field, David
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.03.2004; Elsevier
• Subjects: Biological and medical sciences; Blood Pressure; Extracorporeal Membrane Oxygenation; Female; General aspects; Heart Rate; Humans; Hypothermia, Induced; Infant, Newborn; Interleukin-6 - analysis; Interleukin-8 - analysis; Male; Medical sciences; Pilot Projects; Prospective Studies; ECMO; MABP; ACT; TAT; Human; Pediatrics; Membrane oxygenator; Newborn; Respiratory disease; Respiratory distress; Extracorporeal circuit; Hypothermia
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2003.11.034

To investigate the safety and feasibility of using mild hypothermia in neonates receiving extracorporeal membrane oxygenation (ECMO). A prospective, nonrandomized pilot study of 25 neonates referred for ECMO. Whole body cooling was achieved by adjustment of the temperature of the extracorporeal circuit water bath. Five groups (N = 5 per group) were each studied for the first 5 days of ECMO. The first group was maintained at 37°C throughout the study period. Subsequent groups were cooled to 36°C, to 35°C, and, finally, to 34°C, respectively, for 24 hours and the final group to 34°C for 48 hours before being rewarmed to 37°C. Patients were carefully assessed clinically and biologically. In addition to routine laboratory tests, cytokines (IL-6 and IL-8), complement (C3a), and molecular markers of coagulation (thrombin/antithrombin III [TAT], antithrombin III, and plasmin-α2plasminogen) were measured. No major clinical or circuit problems were noted during cooling or rewarming. In particular, there were no problems of bleeding or cardiac arrhythmia. No significant difference was found between groups in terms of molecular markers of coagulation, complement, cytokines, and platelet transfusions. Applying mild hypothermia (34°C) for 24 or 48 hours to neonates receiving ECMO is both feasible and safe.