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Motor performance after neonatal extracorporeal membrane oxygenation: a longitudinal evaluation
Monique H M van der Cammen-van Zijp1, Anjo J W M Janssen2, Marlou Ma Raets3
1Intensive Care and Department of Pediatric Surgery,Department of Rehabilitation Medicine and Physical Therapy, and.
Pediatrics
|July 23, 2014
Summary
Children treated with neonatal extracorporeal membrane oxygenation (ECMO) show persistent motor deficits throughout childhood. These motor problems worsen with age, particularly by 12 years old.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neonatal Care
Background:
- Neonatal extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for infants with severe respiratory or cardiac failure.
- Long-term neurodevelopmental outcomes, particularly motor performance, in ECMO survivors require continued investigation.
- Understanding post-ECMO motor development is crucial for early intervention and improved long-term health.
Purpose of the Study:
- To longitudinally assess motor performance in children aged 5 to 12 years following neonatal ECMO.
- To identify associations between clinical characteristics and motor performance outcomes in this cohort.
- To evaluate the trajectory of motor development from early to late childhood after ECMO.
Main Methods:
- A cohort of 254 neonatal ECMO survivors in the Netherlands was assessed using the Movement Assessment Battery for Children at ages 5, 8, and 12 years.
- Motor performance scores were converted to z scores for longitudinal analysis, with a norm population mean of 0 and standard deviation of 1.
- Primary diagnoses included meconium aspiration syndrome, congenital diaphragmatic hernia, and persistent pulmonary hypertension of the newborn.
Main Results:
- Motor performance was normal in 73.7% at 5 years, 74.8% at 8 years, and 40.5% at 12 years, significantly lower than expected reference values (P < .001).
- Longitudinal z scores indicated motor deficits, with mean scores of -0.42 at 5 years, -0.25 at 8 years, and -1.00 at 12 years.
- Motor performance declined significantly between 8 and 12 years, with children diagnosed with congenital diaphragmatic hernia experiencing persistent problems and chronic lung disease negatively impacting outcomes.
Conclusions:
- Neonatal ECMO survivors experience persistent motor impairments that become more pronounced during childhood.
- The observed decline in motor function by age 12 highlights the need for ongoing monitoring and support for these children.
- Early identification of risk factors, such as congenital diaphragmatic hernia and chronic lung disease, can inform targeted interventions.
