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Related Concept Videos

Fetal Circulation01:14

Fetal Circulation

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...

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Brain development in newborns and infants after ECMO.

Kai Yan1, Lu-Kun Tang1,2,3, Fei-Fan Xiao1

  • 1Department of Neonatology, Children Hospital of Fudan University, Shanghai, 201102, China.

World Journal of Pediatrics : WJP
|January 18, 2024
PubMed
Summary

Extracorporeal membrane oxygenation (ECMO) can lead to neurodevelopmental issues in neonates. Early detection and intervention are crucial for improving long-term outcomes in ECMO survivors.

Keywords:
Brain developmentExtracorporeal membrane oxygenationInfantsNeonatesNeurological outcomes

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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.