PSYCHOLOGICAL OUTCOME OF ECMO-ELIGIBLE NEONATES WITH SEVERE RESPIRATORY-FAILURE TREATED USING CONVENTIONAL MEDICAL THERAPY

Objective: The present study addressed a National Health and Medical R esearch Council (NHMRC) recommendation that the outcome of neonates wh o are treated conventionally for respiratory problems be further inves tigated before setting up additional extracorporeal membrane oxygenati on (ECMO) centres in Australia. Methodology: The cognitive and behavio ural outcome of ECMO eligible infants who received conventional treatm ent for respiratory problems at birth was assessed in 18 infants aged 1.5-3 years (index group). ECMO was not available at either of the tre ating hospitals. Index children were compared to a matched control gro up of children who did not experience any major complications at birth . Children were assessed using either the Bayley or McCarthy scales of infant development and the Child Behavior Checklist. Results: Overall , a mortality rate of 19% and a psychological morbidity rate of 18% su ggest that children born with severe respiratory failure, who meet exi sting ECMO eligibility criteria, have a good prognosis when treated us ing conventional medical therapy. Conclusions: Improvements to convent ional treatments indicate that ECMO eligibility criteria may need to b e revised to identify accurately those infants who are at extreme risk of mortality if treated conventionally.