Neurodevelopmental, educational and behavioral outcome at 8 years after neonatal ECMO: a nationwide multicenter study

Area of Science:

• Pediatric Medicine
• Neonatal Care
• Neurodevelopmental Pediatrics

Background:

• Neonatal extracorporeal membrane oxygenation (ECMO) is a life-saving procedure for critically ill newborns.
• Long-term neurodevelopmental outcomes following neonatal ECMO require continued investigation.
• Understanding the developmental trajectory of ECMO survivors is essential for optimizing care.

Purpose of the Study:

• To evaluate the neurodevelopmental outcomes of children at age eight who received neonatal ECMO.
• To assess intelligence, concentration, eye-hand coordination, and behavior in this cohort.
• To compare outcomes with normative data to identify specific areas of concern.

Main Methods:

• A follow-up study assessed 135 eight-year-old children treated with neonatal ECMO.
• Neurodevelopmental assessments included intelligence (Revised Amsterdam Intelligence Test), concentration (Bourdon-Vos test), and eye-hand coordination (Developmental Test of Visual-Motor Integration).
• Behavioral assessments utilized the Child Behavior Checklist and Teacher Report Form.

Main Results:

• Intelligence quotient (IQ) was within the normal range (mean 99.9), with 91% attending regular education.
• Significantly more children required special education or extra support compared to normative data.
• Children exhibited slower working speed and reduced accuracy on the Bourdon-Vos test, alongside increased behavioral problems reported by mothers and teachers.

Conclusions:

• Neonatal ECMO survivors demonstrate normal intelligence but face challenges in concentration and behavior at age eight.
• Subtle learning deficits may be present, necessitating focused long-term follow-up.
• Early identification and intervention for learning and behavioral issues are recommended for this population.