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Survivors of neonatal extracorporeal membrane oxygenation at school age: unusual findings on intelligence testing
L Iklé1, D N Iklé, S G Moreland
1Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262, USA. ikle.linda@tchden.org
Insights
Extracorporeal membrane oxygenation (ECMO) for persistent pulmonary hypertension in newborns was linked to unusual IQ patterns in survivors. Longer ECMO duration correlated with higher Performance IQ, suggesting ECMO
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Developmental Psychology
Background:
- Persistent pulmonary hypertension (PPHN) is a severe neonatal condition.
- Extracorporeal membrane oxygenation (ECMO) is a life-support treatment for PPHN.
- Long-term neurodevelopmental outcomes after neonatal critical illness require further investigation.
Purpose of the Study:
- To investigate the neurodevelopmental outcomes, specifically IQ patterns, of children treated with ECMO for PPHN.
- To explore potential correlations between ECMO treatment duration and cognitive performance.
- To understand the complex impact of ECMO on infant brain development.
Main Methods:
- Follow-up study of 17 children treated with ECMO for PPHN in the neonatal period.
- Intelligence testing (IQ) administered at ages 5 to 8 years.
- Analysis of IQ subtest scores, including Verbal and Performance IQ discrepancies and subtest variability.
Main Results:
- ECMO survivors exhibited higher-than-predicted rates of discrepancies between Verbal and Performance IQ.
- A significant percentage of children showed unusual strengths or weaknesses on IQ subtests.
- A positive correlation was found between ECMO duration and Performance IQ scores.
Conclusions:
- Neonatal ECMO for PPHN is associated with unique cognitive profiles in school-aged children.
- The findings suggest that ECMO's impact on the developing infant brain may not be solely detrimental.
- Further research is needed to elucidate the mechanisms behind these observed cognitive patterns.
Abstract:
Data are presented on 17 children who received extracorporeal membrane oxygenation (ECMO) in the neonatal period for persistent pulmonary hypertension (PPHN). These children are being followed as part of a larger program of follow-up research on children who have been treated for PPHN with several treatment methods. On intelligence testing at ages 5 to 8 years, these 17 children had unusual patterns of results. A higher-than-predicted percentage of the ECMO survivors had discrepancies between their Verbal and Performance IQ and a much-higher-than-predicted percentage had areas of unusual strength or weakness on their IQ subtest scores. Also, there was a significant correlation between the amount of time a child received ECMO and the child's Performance IQ: the longer the child received ECMO, the higher the Performance IQ. While findings of unusual weaknesses or deficits on intelligence testing at school age in children who have been severely ill in the neonatal period are not unusual, findings of high scores and areas of strength are not easily explained, particularly when these findings seem to relate to an invasive treatment like ECMO. Similar findings have been reported in two other small studies, which suggest that the impact of ECMO on the developing infant brain may not be purely detrimental.