Predictors and Hospital Outcomes in Pregnant Patients Undergoing Extracorporeal Membrane Oxygenation: A Nationwide Study

Abstract

cesarean delivery is associated with a reduction in body temperature. 7 Before this study, no association between continuous spinal labor analgesia and ERMF had been described, and this finding therefore raises an interesting question about whether ERMF is in fact a misnomer given that it may not be restricted to epidural analgesia per se.Seiler's findings that there is no difference in the incidence or ERMF in parturients undergoing continuous spinal analgesia compared to continuous epidural analgesia is consistent with the hypothesis that ERMF occurs as a result of the neuraxial block's effects on thermoregulation during labor. Further, the reduced consumption of bupivacaine in the spinal analgesia group suggests that the hyperthermic response is unlikely to be dose dependent. Regardless of the true mechanism, we now know that maternal fever occurs just as frequently with continuous spinal analgesia as with epidural analgesia. As a common and potentially deleterious side effect of neuraxial labor analgesia (as well as a differential for maternal sepsis), we advocate for heightened awareness of this phenomenon among laboring patients and all those who treat them.