Ichiba Shingo
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Original article
Language English
Peer review Peer reviewed
Title A pilot investigation of mild hypothermia in neonates receiving extracorporeal membrane oxygenation (ECMO).
Journal Formal name：The Journal of pediatrics
Abbreviation：J Pediatr
ISSN code：00223476/00223476
Domestic / ForeginForegin
Volume, Issue, Page 144(3),pp.301-308
Author and coauthor Horan Marie, Ichiba Shingo, Firmin Richard K, Killer Hilliary M, Edwards David, Azzopardi Denis, Hodge Rachel, Kotecha Sailesh, Field David
Publication date 2004/03
Summary OBJECTIVE:To investigate the safety and feasibility of using mild hypothermia in neonates receiving extracorporeal membrane oxygenation (ECMO). Study design 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 degrees C throughout the study period. Subsequent groups were cooled to 36 degrees C, to 35 degrees C, and, finally, to 34 degrees C, respectively, for 24 hours and the final group to 34 degrees C for 48 hours before being rewarmed to 37 degrees 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-alpha2plasminogen) were measured.RESULTS: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.CONCLUSIONS:Applying mild hypothermia (34 degrees C) for 24 or 48 hours to neonates receiving ECMO is both feasible and safe.
DOI 10.1016/j.jpeds.2003.11.034
PMID 15001932