Neurodevelopmental status at age five years of neonates treated with extracorporeal membrane oxygenation☆,☆☆,★,★★
Section snippets
Subjects
From June 1984 until July 1988, 204 neonates were treated with ECMO in the neonatal intensive care unit at Children's National Medical Center. All infants were outborn and transported to our institution from states within a perimeter that included Maine, Florida, and Ohio. Cardiopulmonary bypass was initiated when an infant failed to respond to medical management and met criteria of cardiorespiratory failure that predicted an 80% mortality rate.18, 19 Details of the ECMO procedure have been
Neurodevelopmental outcome: Major disability
Seventeen ECMO-treated children (17%) had one or more major disabilities: mental disability, motor disability, sensorineural impairment, or seizure disorder.
DISCUSSION
This report summarizes neurodevelopmental sequelae of 103 ECMO-treated neonates at 5 years of age, compared with a control group of 37 five-year-old children with normal birth histories. Given the mortality risk in the neonatal period, the presumed perturbations in cerebral blood flow, and the high rate of neuroimaging abnormality, the 17% rate of major disability among the ECMO survivors is lower than might be expected; however, parental reports of behavioral problems and the risk of academic
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2020, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :The long-term neurologic outcomes of pediatric ECMO survivors have been widely studied over the past 2 decades. Several groups have identified gross motor delays in elementary school age children and ongoing neuropsychological deficits, such as spatial ability, memory, and working speed, through adolescence.116–118 It is imperative to note that the neurodevelopmental assessments of children in these follow-up studies were compared with normal reference ranges.
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From the Center for Child Development, Departments of Behavioral Sciences, Psychology, Neurology, and Neonatology, and the Children's Research Institute, Children's National Medical Center, and the Departments of Pediatrics and Neurology, George Washington University, Washington, D.C.
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Supported in part by a grant (RO1:NS26805) from the National Institute of Neurological Disorders and Stroke, National Institutes of Health (Dr. Glass).
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Reprint requests: Penny Glass, PhD, Director, Center for Child Development, Children's National Medical Center, Washington, DC 20010.
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0022-3476/95/$3.00 + 0 9/23/65708