title: Neurodevelopmental status at age five years of neonates treated with extracorporeal membrane oxygenation.
abstract: 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.
authors.affiliation: Department of Behavioral Sciences, Children's National Medical Center, Washington, D.C. 20010, USA.
authors.forename: P
authors.initials: P
authors.lastname: Glass
authors.forename: A E
authors.initials: AE
authors.lastname: Wagner
authors.forename: P H
authors.initials: PH
authors.lastname: Papero
authors.forename: S R
authors.initials: SR
authors.lastname: Rajasingham
authors.forename: L A
authors.initials: LA
authors.lastname: Civitello
authors.forename: M S
authors.initials: MS
authors.lastname: Kjaer
authors.forename: C E
authors.initials: CE
authors.lastname: Coffman
authors.forename: P R
authors.initials: PR
authors.lastname: Getson
authors.forename: B L
authors.initials: BL
authors.lastname: Short
mesh_terms: 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