title: Adverse neurodevelopmental outcome after extracorporeal membrane oxygenation among neonates with bronchopulmonary dysplasia.
abstract: OBJECTIVE
  The relationship between bronchopulmonary dysplasia (BPD) and neurodevelopmental outcome after extracorporeal membrane oxygenation (ECMO) has not been extensively reported. We compared the outcomes in a large series of infants with and without BPD after ECMO.
  
  
  METHODS
  Hospital charts and follow-up records of 145 infants treated with ECMO (1985 through 1990) were reviewed. Complete long-term respiratory and follow-up outcome data were available in 64 infants. BPD occurred in 17 survivors; the remaining 47 did not have BPD.
  
  
  RESULTS
  Babies with BPD were more likely to have had respiratory distress syndrome. Mean (+/- SD) age at ECMO initiation was later for the BPD group (127+/-66 vs 53+/-39 hours, p < 0.001), and the duration of ECMO treatment was longer (192+/-68 vs 119+/-53 hours, p < 0.001). Bayley Scales of Infant Development scores at <30 months were lower in infants with BPD (p < 0.001), as were three of four Mullen Scales of Early Learning scores (> or = 30 months, p < 0.001 or p = 0.01). At 57+/-16 months 11 (64%) patients with BPD had mild neurologic disabilities, and 3 (18%) had severe disabilities. At a similar age (53+/-16 months, p = NS) 16 (34%) patients without BPD had mild disabilities, whereas 2 (4%) had severe disabilities (p < 0.01).
  
  
  CONCLUSIONS
  The occurrence of BPD after ECMO is associated with adverse neurodevelopmental outcome. Patients with BPD after ECMO merit close long-term follow-up.
authors.affiliation: Department of Pediatrics, Thomas Jefferson University, Jefferson Medical College, Philadelphia, Pennsylvania, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Kornhauser
authors.forename: S
authors.initials: S
authors.lastname: Baumgart
authors.forename: S A
authors.initials: SA
authors.lastname: Desai
authors.forename: C W
authors.initials: CW
authors.lastname: Stanley
authors.forename: J
authors.initials: J
authors.lastname: Culhane
authors.forename: J A
authors.initials: JA
authors.lastname: Cullen
authors.forename: T E
authors.initials: TE
authors.lastname: Wiswell
authors.forename: L J
authors.initials: LJ
authors.lastname: Graziani
authors.forename: A R
authors.initials: AR
authors.lastname: Spitzer
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000628:therapy*; D002658:Developmental Disabilities / Q000209:etiology*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications