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Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
Published on: October 24, 2018
Long-term outcome of children treated with neonatal extracorporeal membrane oxygenation: increasing problems with
Hanneke Ijsselstijn1, Arno F J van Heijst2
1Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Dr. Molewaterplein 60, Rotterdam NL-3015 GJ, The Netherlands.
Insights
Survivors of neonatal extracorporeal membrane oxygenation (ECMO) often face long-term neurodevelopmental challenges. Early recognition and intervention are crucial for improving outcomes in these children.
Area of Science:
- Pediatrics
- Neonatology
- Neurodevelopmental Pediatrics
Background:
- Increasing survival rates for critically ill neonates necessitate evaluation of long-term health.
- Extracorporeal membrane oxygenation (ECMO) is a life-support intervention for neonates with severe respiratory or cardiac failure.
Purpose of the Study:
- To review current medical and neurodevelopmental outcomes in children treated with neonatal ECMO.
- To identify specific long-term morbidities associated with ECMO survivors.
Main Methods:
- This is a review article, synthesizing existing literature on ECMO outcomes.
- Data were gathered from studies evaluating pediatric survivors of neonatal ECMO.
Main Results:
- Most ECMO survivors, excluding those with congenital diaphragmatic hernia (CDH), exhibit normal lung function and growth.
- Maximal exercise capacity is reduced and may decline over time in the CDH population.
- While early mental development is often favorable, school-age children may experience deficits in working speed, spatial abilities, and memory.
Conclusions:
- Neonatal ECMO survivors frequently present with neurodevelopmental problems at school age.
- Long-term follow-up is essential for early identification and intervention of these issues.
Abstract:
As more and more critically ill neonates survive, it becomes important to evaluate long-term morbidity. This review aims to provide an up-to-date overview of medical and neurodevelopmental outcomes in children who as neonates received treatment with extracorporeal membrane oxygenation (ECMO). Most patients-except those with congenital diaphragmatic hernia-have normal lung function and normal growth at older age. Maximal exercise capacity is below normal and seems to deteriorate over time in the CDH population. Gross motor function problems have been reported until school age. Although mental development is usually favorable within the first years and cognition is normal at school age, many children experience problems with working speed, spatial ability tasks, and memory. In conclusion, children who survived neonatal treatment with ECMO often encounter neurodevelopmental problems at school age. Long-term follow-up is needed to recognize problems early and to offer appropriate intervention.
