title: Growing Up After Critical Illness: Verbal, Visual-Spatial, and Working Memory Problems in Neonatal Extracorporeal Membrane Oxygenation Survivors.
abstract: To assess neuropsychologic outcome in 17- and 18-year-old neonatal extracorporeal membrane oxygenation survivors.
  
  
  
  A prospective longitudinal follow-up study.
  
  
  
  Follow-up program at the Erasmus MC-Sophia Children's Hospital in Rotterdam, The Netherlands.
  
  
  
  Thirty adolescents 17 or 18 years old, treated between 1991 and 1997, underwent neuropsychologic assessment.
  
  
  
  None.
  
  
  
  Attention, memory, executive functioning, visual-spatial functions, social-emotional functioning, and behavior were assessed with validated instruments, and data were compared with reference data. Included predictors for analysis of adverse outcome were diagnosis, age at start extracorporeal membrane oxygenation, convulsions, and use of antiepileptics. Adolescents' performance (expressed as mean [SD] z score) was significantly lower than the norm on short-term and long-term verbal memory (z score = -1.40 [1.58], p = 0.016; z score = -1.54 [1.67], p = 0.010, respectively), visual-spatial memory (z score = -1.65 [1.37], p = 0.008; z score = -1.70 [1.23], p = 0.008, respectively), and working memory (32% vs 9% in the norm population). Parents reported more problems for their children regarding organization of materials (z score = -0.60 [0.90]; p = 0.03) and behavior evaluation (z score = -0.53 [0.88]; p = 0.05) on a questionnaire. Patients reported more withdrawn/depressed behavior (z score = -0.47 [0.54]; p = 0.02), somatic complaints (z score = -0.43 [0.48]; p = 0.03), and social problems (z score = -0.41 [0.46]; p = 0.04). Patients reported more positive feelings of self-esteem and an average health status.
  
  
  
  Adolescents treated with neonatal extracorporeal membrane oxygenation are at risk of verbal, visual-spatial, and working memory problems. Future research should focus on 1) the longitudinal outcome of specific neuropsychologic skills in adolescence and adulthood; 2) identifying risk factors of neuropsychologic dysfunction; 3) evaluating to what extent "severity of illness" is responsible for acquired brain injury; and 4) effects of timely cognitive rehabilitation.
authors.affiliation: 1Intensive Care Unit, Department of Pediatric Surgery Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. 2Department of Neonatology Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marlous J
authors.initials: MJ
authors.lastname: Madderom
authors.forename: Raisa M
authors.initials: RM
authors.lastname: Schiller
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Gischler
authors.forename: Arno F J
authors.initials: AF
authors.lastname: van Heijst
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Femke K
authors.initials: FK
authors.lastname: Aarsen
authors.forename: Hanneke
authors.initials: H
authors.lastname: IJsselstijn
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001288:Attention; D016638:Critical Illness; D004522:Educational Status; D056348:Emotional Intelligence; D004644:Emotions; D056344:Executive Function; D015199:Extracorporeal Membrane Oxygenation / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D065630:Hernias, Diaphragmatic, Congenital / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000628:therapy; D008570:Memory, Short-Term; D009483:Neuropsychological Tests; D010290:Parents; D011446:Prospective Studies; D012649:Self Concept; D065855:Spatial Processing; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*