Neurodevelopmental status at age five years of neonates treated with extracorporeal membrane oxygenation.
OBJECTIVE
To determine the neurodevelopmental status at age 5 years among children who received extracorporeal membrane oxygenation (ECMO) in the newborn period as a treatment for severe cardiorespiratory failure.


METHODS
We conducted a prospective cohort study of 103 five-year-old ECMO-treated children born between June 1984 and July 1988, and treated at our institution. Thirty-seven healthy control children were recruited locally. The assessment protocol included a complete neuropsychologic assessment, psychosocial assessment with parent questionnaires, a standard neurologic evaluation, assessment of gross motor and fine motor function, a medical history, and physical examination.


RESULTS
Major disability was present in 17 of the ECMO cohort. Eleven ECMO-treated children (11%) were mentally retarded, one of whom was profoundly impaired. Two additional children had severe learning disabilities. Cerebral palsy was diagnosed in 5 (5%) ECMO-treated children, but all cases were mild in nature and the patients were walking unaided. One child has paraplegia. The mean Full Scale, Verbal, and Performance IQs of the EMCO-treated children were within the normal range, but as a group were significantly lower than in control children (96 vs 115, p < 0.001). Children treated with ECMO had increased risk relative to the control children for academic difficulties at school age (49% VS 22%, P < 0.01) and a higher rate of behavioral problems reported by parents (42% vs 16%, p = 0.01).


CONCLUSIONS
The rate of major disability was comparable to that in other high-risk populations. The high rate of behavioral problems and increased risk of subsequent school failure among nonretarded ECMO-treated children supports the need for close follow-up of these children after hospital discharge.
Glass
P
P
Department of Behavioral Sciences, Children's National Medical Center, Washington, D.C. 20010, USA.
Wagner
A E
AE
Papero
P H
PH
Rajasingham
S R
SR
Civitello
L A
LA
Kjaer
M S
MS
Coffman
C E
CE
Getson
P R
PR
Short
B L
BL
D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009420:Nervous System / Q000254:growth & development*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011446:Prospective Studies; D002666:Psychology, Child; D011593:Psychology, Social; D012306:Risk