ADVERSE NEURODEVELOPMENTAL OUTCOME AFTER EXTRACORPOREAL MEMBRANE-OXYGENATION AMONG NEONATES WITH BRONCHOPULMONARY DYSPLASIA

Objective: The relationship between bronchopulmonary dysplasia (BPD) a nd neurodevelopmental outcome after extracorporeal membrane oxygenatio n (ECMO) has not been extensively reported. We compared the outcomes i n a large series of infants with and without BPD after ECMO. Study des ign: Hospital charts and follow-up records of 145 infants treated with ECMO (1985 through 1990) were reviewed. Complete long-term respirator y and follow-up outcome data were available in 64 infants. BPD occurre d in 17 sur vivors; the remaining 47 did not have BPD. Results: Babies with BPD were more likely to have had respiratory distress syndrome. Mean (+/- SD) age at ECMO initiation was later for the BPD group (127 +/- 66 vs 53 +/- 39 hours, p < 0.001), and the duration of ECMO treatm ent was longer (192 +/- 68 vs 119 +/- 53 hours, p < 0.001). Bayley Sca les of Infant Development scores at <30 months were lower in infants w ith BPD (p < 0.001), as were three of four Mullen Scales of Early Lear ning scores (greater than or equal to 30 months, p < 0.001 or p = 0.01 ). At 57 +/- 16 months 11 (64%) patients with BPD had mild neurologic disabilities, and 3 (18%) had severe disabilities. At a similar age (5 3 +/- 16 months, p = NS) 16 (34%) patients without BPD had mild disabi lities, whereas 2 (4%) had severe disabilities (p < 0.01). Conclusions : The occurrence of BPD after ECMO is associated with adverse neurodev elopmental outcome. Patients with BPD after ECMO merit close longterm follow-up.