title: Congenital diaphragmatic hernia with(out) ECMO: impaired development at 8 years.
abstract: OBJECTIVE
  To evaluate developmental and social-emotional outcomes at 8 years of age for children with congenital diaphragmatic hernia (CDH), treated with or without neonatal extracorporeal membrane oxygenation (ECMO) between January 1999 and December 2003.
  
  
  METHODS
  Cohort study with structural prospective follow-up.
  
  
  METHODS
  Level III University Hospital.
  
  
  METHODS
  35 children (ECMO: n=16; non-ECMO: n=19) were assessed at 8 years of age.
  
  
  METHODS
  None.
  
  
  METHODS
  Intelligence and motor function. Concentration, behaviour, school performance, competence and health status were also analysed.
  
  
  RESULTS
  Mean (SD) intelligence for the ECMO group was 91.7 (19.5) versus 111.6 (20.9) for the non-ECMO group (p=0.015). Motor problems were apparent in 16% of all participants and differed significantly from the norm (p=0.015) without differences between treatment groups. For all participants, problems with concentration (68%, p<0.001) and with behavioural attention (33%, p=0.021) occurred more frequently than in reference groups, with no difference between treatment groups. School performance and competence were not affected.
  
  
  CONCLUSIONS
  Children with CDH-whether or not treated with neonatal ECMO-are at risk for long-term morbidity especially in the areas of motor function and concentration. Despite their impairment, children with CDH have a well-developed feeling of self-competence.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Dr. Molewaterplein 60; Rotterdam, The Netherlands.
authors.forename: Marlous J
authors.initials: MJ
authors.lastname: Madderom
authors.forename: Leontien
authors.initials: L
authors.lastname: Toussaint
authors.forename: Monique H M
authors.initials: MH
authors.lastname: van der Cammen-van Zijp
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Gischler
authors.forename: René M H
authors.initials: RM
authors.lastname: Wijnen
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Hanneke
authors.initials: H
authors.lastname: Ijsselstijn
mesh_terms: D002648:Child; D002657:Child Development; D002658:Developmental Disabilities / Q000209:etiology*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006548:Hernia, Diaphragmatic / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007360:Intelligence; D007859:Learning Disabilities / Q000209:etiology; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D009426:Netherlands; D011597:Psychomotor Performance; D012307:Risk Factors; D012720:Severity of Illness Index; D012920:Social Behavior Disorders / Q000209:etiology