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Safety of therapeutic hypothermia in children on veno-arterial extracorporeal membrane oxygenation after cardiac surgery

Published online by Cambridge University Press:  27 February 2015

Song Lou ,
Graeme MacLaren ,
Eldho Paul ,
Derek Best ,
Carmel Delzoppo ,
Yves d’Udekem  and
Warwick Butt
Song Lou
Affiliation:
Paediatric Intensive Care Unit, Royal Children’s Hospital, Parkville, Melbourne, Australia State Key Laboratory of Cardiovascular Disease, Department of Cardiopulmonary Bypass, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, People’s Republic of China
Graeme MacLaren*
Affiliation:
Paediatric Intensive Care Unit, Royal Children’s Hospital, Parkville, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Cardiothoracic Intensive Care Unit, National University Health System, Singapore
Eldho Paul
Affiliation:
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Derek Best
Affiliation:
Paediatric Intensive Care Unit, Royal Children’s Hospital, Parkville, Melbourne, Australia
Carmel Delzoppo
Affiliation:
Paediatric Intensive Care Unit, Royal Children’s Hospital, Parkville, Melbourne, Australia
Yves d’Udekem
Affiliation:
Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Department of Cardiac Surgery, The Royal Children’s Hospital, Melbourne, Victoria, Australia
Warwick Butt
Affiliation:
Paediatric Intensive Care Unit, Royal Children’s Hospital, Parkville, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
*
Correspondence to: G. MacLaren, c/o Paediatric Intensive Care Unit, Royal Children’s Hospital, Flemington Rd, Parkville, VIC 3052, Australia. Tel: +6 139 345 5211; Fax: +6139 345 5977; E-mail: gmaclaren@iinet.net.au
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Abstract

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).

Conclusion

Therapeutic hypothermia can be safely provided to children on extracorporeal membrane oxygenation after cardiac surgery without an increase in complication rates.

Keywords

Extracorporeal life supportpaediatricoutcomesbleeding
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 7 , October 2015 , pp. 1367 - 1373
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Copyright
© Cambridge University Press 2015 

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Footnotes

The work was performed at the Royal Children’s Hospital, Melbourne, Australia.

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