Safety of therapeutic hypothermia in children on veno-arterial extracorporeal membrane oxygenation after cardiac surgery.
OBJECTIVE
The aim of this study was to evaluate whether the use of therapeutic hypothermia in patients receiving extracorporeal membrane oxygenation after paediatric cardiac surgery is associated with increased complication rates.


METHODS
We undertook a retrospective study to compare the complication rates and clinical course of children after cardiac surgery in two groups – extracorporeal membrane oxygenation without therapeutic hypothermia (group 1) and extracorporeal membrane oxygenation with therapeutic hypothermia (group 2). Therapeutic hypothermia was performed via the extracorporeal membrane oxygenation circuit heater-cooler device.


RESULTS
A total of 96 patients were included in this study (59 in group 1 and 37 in group 2). Complications were comparable between group 1 and group 2, except that more patients with therapeutic hypothermia had hypertension while on extracorporeal membrane oxygenation. Therapeutic hypothermia was not independently associated with in-hospital mortality (adjusted odds ratio 1.16, 95% CI: 0.33-4.03; p=0.82).


CONCLUSIONS
Therapeutic hypothermia can be safely provided to children on extracorporeal membrane oxygenation after cardiac surgery without an increase in complication rates.
1Paediatric Intensive Care Unit,Royal Children's Hospital,Parkville,Melbourne,Australia.
Song
S
Lou
1Paediatric Intensive Care Unit,Royal Children's Hospital,Parkville,Melbourne,Australia.
Graeme
G
MacLaren
John
J
Clark
5School of Public Health and Preventive Medicine,Monash University,Melbourne,Australia.
Eldho
E
Paul
1Paediatric Intensive Care Unit,Royal Children's Hospital,Parkville,Melbourne,Australia.
Derek
D
Best
1Paediatric Intensive Care Unit,Royal Children's Hospital,Parkville,Melbourne,Australia.
Carmel
C
Delzoppo
3Department of Paediatrics,University of Melbourne,Melbourne,Victoria,Australia.
Yves
Y
d'Udekem
1Paediatric Intensive Care Unit,Royal Children's Hospital,Parkville,Melbourne,Australia.
Warwick
W
Butt
D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
Extracorporeal life support; bleeding; outcomes; paediatric