In-hospital outcomes of neonates with hypoxic-ischemic encephalopathy receiving extracorporeal membrane oxygenation

J Perinatol. 2019 May;39(5):661-665. doi: 10.1038/s41372-019-0345-6. Epub 2019 Mar 6.

Abstract

Objective: To determine in-hospital outcomes of neonates with hypoxic ischemic encephalopathy (HIE) requiring extracorporeal membrane oxygenation (ECMO).

Study design: Single-center retrospective study from 2005 to 2016 of neonates ≥35 weeks gestation with moderate/severe HIE, requiring ECMO for persistent pulmonary hypertension of newborn (PPHN).

Results: Our cohort (n = 20) received therapeutic hypothermia for moderate (n = 12), severe (n = 5), or undocumented severity (n = 3) of HIE. During ECMO, 30% (n = 6) infants developed intracranial hemorrhage at a median (IQR) duration of 24 (20) hours. Sixteen (80%) infants survived to discharge, among which 15 had MRI performed; 47% (n = 7) had normal MRI, 20% (n = 3) had intracranial hemorrhage and 13% (n = 2), 13% (n = 2) and 7% (n = 1) had NICHD stage 1, 2, and 3 pattern of brain injury respectively.

Conclusions: In this high-risk population of neonates, use of ECMO was safe and efficacious as demonstrated by survival and outcomes.

MeSH terms

  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Female
  • Hospital Mortality
  • Humans
  • Hypothermia, Induced
  • Hypoxia-Ischemia, Brain / mortality*
  • Hypoxia-Ischemia, Brain / physiopathology
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Intracranial Hemorrhages / etiology*
  • Magnetic Resonance Imaging
  • Male
  • Michigan
  • Persistent Fetal Circulation Syndrome / etiology*
  • Retrospective Studies
  • Treatment Outcome