title: Neuropsychological Follow-up After Neonatal ECMO.
abstract: To assess the longitudinal development of intelligence and its relation to school performance in a nationwide cohort of neonatal extracorporeal membrane oxygenation (ECMO) survivors and evaluate predictors of outcome at 8 years of age.
  
  
  
  Repeated measurements assessed intelligence of neonatal ECMO survivors at 2, 5, and 8 years (n = 178) with the use of validated, standardized instruments. Selective attention (n = 148) and type of education were evaluated in the 8-year-olds.
  
  
  
  Intelligence remained stable and average across development (mean ± SD IQ: at 2 years, 102 ± 18; at 5 years, 100 ± 17; and at 8 years, 99 ± 17 [P = .15]). Children attending regular education without the need for help (n = 101; mean z score: -1.50 ± 1.93) performed significantly better on the selective attention task compared with those children who needed extra help (n = 65; mean z score: -2.54 ± 3.18) or those attending special education (n = 13; mean z score: -4.14 ± 3.63) (P = .03). However, only children attending special education had below-average intelligence (mean IQ: 76 ± 15), compared with average intelligence for those attending regular education, both with help (mean IQ: 95 ± 15) and without help (mean IQ: 105 ± 16). Compared with children with other diagnoses, children with congenital diaphragmatic hernia (CDH) scored significantly lower on both IQ (CDH, mean IQ: 93 ± 20; meconium aspiration syndrome, mean IQ: 100 ± 15; other diagnoses, mean IQ: 100 ± 19 [P = .04]) and selective attention (CDH, mean z score: -3.48 ± 3.46; meconium aspiration syndrome, mean z score: -1.60 ± 2.13; other diagnoses, mean z score: -1.65 ± 2.39 [P = .002]).
  
  
  
  For the majority of neonatal ECMO survivors, intelligence testing alone did not identify those at risk for academic problems. We propose internationally standardized follow-up protocols that focus on long-term, problem-oriented neuropsychological assessment.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; and.
authors.forename: Raisa M
authors.initials: RM
authors.lastname: Schiller
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; and.
authors.forename: Marlous J
authors.initials: MJ
authors.lastname: Madderom
authors.affiliation: Departments of Medical Psychology, and.
authors.forename: Jolanda J C M
authors.initials: JJ
authors.lastname: Reuser
authors.affiliation: Neonatology, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Katerina
authors.initials: K
authors.lastname: Steiner
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; and.
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Gischler
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; and.
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.affiliation: Neonatology, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Arno F J
authors.initials: AF
authors.lastname: van Heijst
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; and h.ijsselstijn@erasmusmc.nl.
authors.forename: Hanneke
authors.initials: H
authors.lastname: IJsselstijn
mesh_terms: D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D016208:Databases, Factual; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D065630:Hernias, Diaphragmatic, Congenital / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D007361:Intelligence Tests; D007804:Language Development; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011597:Psychomotor Performance; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D017741:Survivors; D013997:Time Factors