Tomonori Kurimoto, Takuya Tokuhisa, Itaru Hayasaka, Tsuyoshi Yamamoto, Eiji Hirakawa, Hiroshi Ohashi, Masaya Kibe, Asataro Yara, Takatsugu Maeda, Masato Kamitomo, Satoshi Ibara
Kagoshima City Hospital. Nikko Memorial Hospital.
Japan
Children
Children 2025; 12:
DOI: 10.3390/children12050605
Abstract
Background/objectives: Hypoxic-ischemic encephalopathy (HIE), affecting 1.3-1.7/1000 live births, is treated with conventional therapeutic hypothermia (TH) but carries significant mortality and neurological impairment. Here, we compared intravascular cooling with extracorporeal membrane oxygenation (ECMO) and conventional TH in neonates with moderate to severe HIE.
Methods: We retrospectively analyzed single-center neonates born in 2000-2022. Neonates with a 10 min Apgar score ≤ 3 or umbilical artery pH ≤ 6.7, along with persistent pulmonary hypertension of the newborn and an oxygenation index of ≥25 to <40, were divided into ECMO (n = 17) and conventional TH (n = 18) groups and administered the Kyoto Scale of Psychological Development at 18 months.
Results: Neonatal and maternal characteristics were similar between the groups. A significantly higher proportion of the ECMO group (70.6% vs. 33.3%) achieved a developmental quotient ≥ 70.
Conclusions: Intravascular cooling with ECMO may improve the neurodevelopmental outcomes of neonates with HIE, severe acidosis, and low Apgar scores.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Symptoms and Findings Associated with Pulmonary Vascular Disease
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes