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

Objective: To determine the neurodevelopmental status at age 5 years a mong children who received extracorporeal membrane oxygenation (ECMO) in the newborn period as a treatment for severe cardiorespiratory fail ure. Methods: We conducted a prospective cohort study of 103 five-year -old ECMO-treated children born between June 1984 and July 1988, and t reated at our institution. Thirty-seven healthy control children were recruited locally. The assessment protocol included a complete neurops ychologic assessment, psychosocial assessment with parent questionnair es, a standard neurologic evaluation, assessment of gross motor and fi ne motor function, a medical history, and physical examination. Result s: Major disability was present in 17 of the ECMO cohort. Eleven ECMO- treated children (11%) were mentally retarded, one of whom was profoun dly impaired. Two additional children had severe learning disabilities . Cerebral palsy was diagnosed in 5 (5%) ECMO-treated children, but al l cases were mild in nature and the patients were walking unaided. One child has paraplegia, The mean Full Scale, Verbal, and Performance IQ s 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 t he control children for academic difficulties at school age (49% vs 22 %, p < 0.01) and a higher rate of behavioral problems reported by pare nts (42% vs 16%, p = 0.01), Conclusions: The rate of major disability was comparable to that in other high-risk populations. The high rate o f behavioral problems and increased risk of subsequent school failure among nonretarded ECMO-treated children supports the need for close fo llow-up of these children after hospital discharge.