NEST trial - Whole body cooling for neonates undergoing extracorporeal membrane oxygenation (ECMO)
David Field (University of Leicester)
Richard Firmin (Glenfield Hospital, Leicester), Frances Cowan (Hammersmith Hospital, London), Denis Azzopardi (Hammersmith Hospital, Imperial College, London), Peter Brocklehurst (NPEU)
Care of the compromised term infant, Child health and development
British Heart Foundation
Extra corporeal membrane oxygenation (ECMO) is an invasive form of life support that can be used in patients with severe cardiorespiratory failure.
Relatively mature (≥ 35 weeks gestational age) newborn infants have been the biggest patient group to receive ECMO and good evidence exists to support this practice.
However data from randomised trials indicates that despite improved survival and reduced morbidity amongst newborns who receive ECMO, rates of neurodevelopmental impairment remain high.
Accumulating evidence in other intensive care settings suggests that mild hypothermia at the time of going on to ECMO has the potential to reduce cerebral damage by providing a degree of neuroprotection.
This trial assessed whether mild total body hypothermia can result in improved neurodevelopmental outcome after ECMO in the early neonatal period.