Subscribe to RSS
DOI: 10.1055/s-0029-1241872
© Georg Thieme Verlag KG Stuttgart · New York
Pulmonary Hypertensive Crisis Requiring ECMO Associated with Re-warming from whole Body Hypothermia for Hypoxic Ischemic Encephalopathy: Clinical Observations from a Case Series
Publication History
Publication Date:
28 October 2009 (online)

Introduction
Hypothermia reduces the risk of death and/or disability in infants with moderate to severe hypoxic ischemic encephalopathy (HIE) [1]. Due to its apparent safety/efficacy, this technique is gaining in popularity. While pulmonary hypertension (PHTN) is a known potential risk associated with hypothermia (20–30%) [2], the associated frequency may be higher than previously described.
Our center routinely treats patients with moderate to severe HIE with hypothermia according to a previously published protocol [3]. Since December 2005, approximately 30 infants have been treated at our center. This communication describes our clinical observation of a higher than expected occurrence of severe pulmonary hypertensive crisis requiring extracorporeal membrane oxygenation (ECMO) associated with re-warming from whole body hypothermia.
References
- 1
Shankaran S, Laptook AR, Ehrenkranz RA. et al .
Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy.
N Engl J Med.
2005;
353
1574-1584
Reference Ris Wihthout Link
- 2
Gluckman PD, Wyatt JS, Azzopardi D. et al .
Selective head cooling with mild systemic hypothermia after neonatal encephalopathy:
Multicentre randomised trial.
Lancet.
2005;
365
663-670
Reference Ris Wihthout Link
- 3
Shankaran S, Laptook A, Wright LL. et al .
Whole-body hypothermia for neonatal encephalopathy: Animal observations as a basis
for a randomized, controlled pilot study in term infants.
Pediatrics.
2002;
110
377-385
Reference Ris Wihthout Link
- 4
Jacobs S, Hunt R, Tarnow-Mordi W. et al .
Cooling for newborns with hypoxic ischaemic encephalopathy (review).
Cochrane Database Syst Rev.
2007;
4
CD003311
Reference Ris Wihthout Link
- 5
Eicher DJ, Wagner CL, Katikaneni LP. et al .
Moderate hypothermia in neonatal encephalopathy: Safety outcomes.
Pediatr Neurol.
2005;
32
18-24
Reference Ris Wihthout Link
- 6
Shankaran S, Pappas A, Laptook AR. et al .
Outcomes of safety and effectiveness in a multicenter randomized, controlled trial
of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy.
Pediatrics.
2008;
122
e791-e798
Reference Ris Wihthout Link
- 7 Stoll BJ, Kliegman RM. Nervous system disorders. In: Behrman RE, Kliegman RM, Jenson HB. Nelson Textbook of Pediatrics 17th ed. Philadelphia: Saunders 2004: 561-569
Reference Ris Wihthout Link
- 8
Thoresen M, Whitelaw A.
Cardiovascular changes during mild therapeutic hypothermia and rewarming in infants
with hypoxic-ischemic encephalopathy.
Pediatrics.
2000;
10
92-99
Reference Ris Wihthout Link
Correspondence
Dr. Charles S. Cox Jr
University of Texas Medical School at Houston
Department of Pediatric Surgery
6431 Fannin Street, MSB 5.236
Houston, TX 77030
United States
Phone: +1713 500 7307
Fax: +1713 500 7296
Email: charles.s.cox@uth.tmc.edu