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Neurodevelopmental Outcomes of Pediatric Cardiac Extracorporeal Membrane Oxygenation Survivors With Central
Ozlem Saritas Nakip1, Selman Kesici1, Gokcen Duzgun Konuskan1
1Ozlem Saritas Nakip, Selman Kesici, Gokcen Duzgun Konuskan, Hacettepe University Faculty of Medicine, Ankara, 06560, Türkiye; Mutlu Uysal Yazici, Gazi University, Faculty of Medicine, Ankara, 06500, Türkiye; Bahadır Konuskan, Ankara Etlik Integrated Health Campus, Ankara, 06170, Türkiye; and Benan Bayrakci, Hacettepe University Faculty of Medicine, Ankara, 06560, Türkiye.
Insights
Pediatric cardiac extracorporeal membrane oxygenation (ECMO) survivors face high risks of neurodevelopmental issues. Over half were discharged, but most experienced developmental delays, motor, or cognitive dysfunction.
Area of Science:
- Pediatric critical care medicine
- Cardiovascular surgery
- Neurodevelopmental outcomes
Background:
- Extracorporeal life support, including pediatric cardiac extracorporeal membrane oxygenation (ECMO), carries substantial mortality and morbidity risks.
- Assessing long-term neurodevelopmental outcomes in survivors is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate the neurodevelopmental outcomes of pediatric cardiac ECMO survivors treated with central cannulation.
- To identify potential risk factors associated with neurodevelopmental deficits in this population.
Main Methods:
- Retrospective evaluation of pediatric patients who received cardiac ECMO with central cannulation.
- Assessment of neurodevelopmental status, including developmental, motor, and cognitive functions.
- Analysis of correlations between ECMO parameters, patient characteristics, and neurodevelopmental outcomes.
Main Results:
- 51.1% of pediatric cardiac ECMO survivors with central cannulation were discharged.
- High rates of neurodevelopmental sequelae were observed: 82.7% developmental delay, 58.8% motor dysfunction, and 70.6% cognitive dysfunction.
- Younger age at ECMO was associated with motor dysfunction (p=0.04), and higher PRISM scores correlated with abnormal developmental status (p=0.03).
Conclusions:
- Pediatric cardiac ECMO survivors exhibit a high burden of neurodevelopmental deficits.
- While no significant correlation was found with ECMO duration or lactate levels, factors like age and disease severity may contribute to neurodevelopmental delay.
- Further research is needed to elucidate specific risk factors and develop targeted interventions.
Abstract:
Extracorporeal life support, such as pediatric cardiac extracorporeal membrane oxygenation (ECMO), is associated with significant mortality and morbidity risk. This study evaluated cardiac ECMO survivors with central cannulation and found that 51.1% were discharged from the hospital. The study also revealed high rates of developmental delay (82.7%), motor dysfunction (58.8%), and cognitive dysfunction (70.6%) among survivors. No significant correlation was found between the duration of ECMO, age at ECMO, pre-ECMO maximum lactate levels, and cognitive scores. Participants with motor dysfunction were significantly younger (p = 0.04). PRISM scores of those with an abnormal developmental status were significantly higher (p = 0.03). Logistic regression analysis did not show a significantly increased risk. Factors such as age, disease severity, and ECMO itself were identified as potential contributors to neurodevelopmental delay.
