• Intensive care medicine · Sep 2013

    Multicenter Study

    Neurodevelopmental, educational and behavioral outcome at 8 years after neonatal ECMO: a nationwide multicenter study.

    • Joost van Rosmalen, Marlous J Madderom, Jolanda J C M Reuser, Elisabeth M W J Utens, Marlou Raets, Paul Govaert, Katerina Steiner, Saskia J Gischler, and Hanneke Ijsselstijn.
    • Intensive Care and Department of Paediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Room Sk 1280; dr. Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands.
    • Intensive Care Med. 2013 Sep 1;39(9):1584-93.

    PurposeReporting neurodevelopmental outcome of 8-year-old children treated with neonatal extracorporeal membrane oxygenation (ECMO).MethodsIn a follow-up study in 135 8-year-old children who received neonatal ECMO between 1996 and 2001 we assessed intelligence (Revised Amsterdam Intelligence Test), concentration (Bourdon-Vos test), eye-hand coordination (Developmental Test of Visual-Motor Integration) and behavior (Child Behavior Checklist and Teacher Report Form).ResultsIntelligence fell within normal range (mean IQ 99.9, SD 17.7, n = 125) with 91 % of the children following regular education. Significantly more children attended special education (9 %) or received extra support in regular education (39 %) compared with normative data. Slower working speed (χ(2) = 132.36, p < 0.001) and less accuracy (χ(2) = 12.90, p < 0.001) were found on the Bourdon-Vos test (n = 123) compared with normative data. Eye-hand coordination fell within the normal range (mean 97.6, SD 14.3, n = 126); children with congenital diaphragmatic hernia scored lowest but still normally (mean 91.0, SD 16.4, n = 28). Mothers (n = 117) indicated more somatic and attention behavior problems; teachers (n = 115) indicated more somatic, social, thought, aggression and total problems compared with normative data. Mothers indicated more somatic problems than teachers (p = 0.003); teachers reported more attention problems than mothers (p = 0.036; n = 111).ConclusionsEight-year-old children treated with neonatal ECMO fall in the normal range of intelligence with problems with concentration and behavior. Long-term follow-up for children treated with neonatal ECMO should focus on early detection of (subtle) learning deficits.

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