CLINICAL ANTECEDENTS OF NEUROLOGIC AND AUDIOLOGICAL ABNORMALITIES IN SURVIVORS OF NEONATAL EXTRACORPOREAL MEMBRANE-OXYGENATION

Extracorporeal membrane oxygenation is an effective rescue treatment f or severe cardiorespiratory failure in term or near-term neonates, alt hough cerebral palsy, mental retardation, and sensorineural hearing lo ss are observed in 10 to 20% of survivors. The objective of the presen t study was to identify potential risk factors that may explain the ne urologic and audiologic sequelae noted in 19% of 181 survivors of neon atal extracorporeal membrane oxygenation hom our hospital. Our results suggest the following findings in survivors of severe cardiorespirato ry failure treated with neonatal extracorporeal membrane oxygenation: (1) hypotension or the need for cardiopulmonary resuscitation before e xtracorporeal membrane oxygenation significantly increases the risk of spastic cerebral palsy, (2) profound hypocarbia before extracorporeal membrane oxygenation is associated with a significantly increased ris k of hearing loss, (3) mental retardation in the absence of spastic ce rebral palsy is unexplained except when due to abnormal fetal brain de velopment, and (4) hypoxemia in the absence of hypotension does not in crease the risk of neurologic or audiologic sequelae.