Brain development in newborns and infants after ECMO

Area of Science:

• Neonatal care
• Neuroscience
• Pediatric intensive care

Background:

• Extracorporeal membrane oxygenation (ECMO) improves survival in critically ill neonates.
• ECMO is also linked to long-term neurodevelopmental challenges in infants.
• Understanding these outcomes is vital for optimizing infant care.

Purpose of the Study:

• To systematically review neurodevelopmental outcomes in neonates and infants post-ECMO.
• To identify incidence, prevalence, and risk factors for motor, cognitive, and sensory deficits.
• To explore current nursing and management strategies for ECMO survivors.

Main Methods:

• Comprehensive literature search across PubMed, EMBASE, and Web of Science.
• Screening of titles/abstracts, followed by full-text assessment of relevant studies.
• Quality evaluation of studies and citation searches for comprehensive data retrieval.

Main Results:

• Approximately 50% of neonates post-ECMO show brain injury, with neurological complications.
• Seizures (18-23%) and bleeding events (27-60%) are common; ischemic strokes occur in up to 33%.
• ECMO may be associated with developmental delays, impacting cognitive, motor, and language functions, though sensory impacts remain unclear.

Conclusions:

• Further large-scale, long-term studies are needed to fully elucidate ECMO's impact on infant neurodevelopment.
• Optimized management, nursing care, patient selection, and early rehabilitation are key to improving outcomes.
• Early detection and multidisciplinary follow-up are essential for ECMO survivors.