Swosti Joshi, Vilmaris Quinones Cardona, Erica Poletto, Ogechukwu Menkiti
Drexel University College of Medicine Philadelphia. Saint Christopher’s Hospital for Children.
United States
American Journal of Perinatology
Am J Perinatol 2022;
DOI: 10.1055/a-1786-8688
Abstract
Objective: Safety and efficacy data on controlled hypothermia (CH) for neonates with moderate to severe hypoxic ischemic encephalopathy has been extrapolated to a subgroup of these patients who also require extracorporeal membrane oxygenation for refractory persistent pulmonary hypertension of the newborn (PPHN). However, safety data on the concomitant use of CH and extracorporeal membrane oxygenation (ECMO) are lacking.
Methods: This is a single-center retrospective study of neonates ≥35 weeks’ gestation with refractory PPHN who required ECMO between January 2010 and December 2020. Study groups were divided into those receiving CH/ECMO versus ECMO only. Baseline characteristics, short-term outcomes, and brain magnetic resonance imaging (MRI) data were compared.
Results: A total of 36 neonates who received ECMO for refractory PPHN were included. Of these, 44.4% (n = 16) received CH/ECMO and 55.6% (n = 20) received ECMO only. Bleeding complications were more common in CH/ECMO group 50% (n = 8) versus ECMO only 15% (n = 3, p = 0.023). T1 brain MRI severity scores were higher in CH/ECMO group versus ECMO only group, however, there were no statistical difference in T2 and diffusion-weighted image scores. Functional status and survival to discharge were comparable between groups.
Conclusion: In our cohort, neonates who received CH/ECMO had higher bleeding complications than ECMO only group with comparable functional status and survival at discharge.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Medical Therapy. Adverse Effects or Lack of Adverse Effects
ge Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
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