NEURODEVELOPMENTAL STATUS AT AGE 5 YEARS OF NEONATES TREATED WITH EXTRACORPOREAL MEMBRANE-OXYGENATION

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 ECMO-treated children were within the normal range, but as a group were significantly lower than in control children (96 vs 1 15, 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.