Standardized therapies after ECMO program (STEP); a novel approach to pediatric post-ECMO care

Area of Science:

• Pediatric critical care medicine
• Extracorporeal membrane oxygenation (ECMO) outcomes
• Neurodevelopmental follow-up

Background:

• Pediatric patients requiring extracorporeal membrane oxygenation (ECMO) often face long-term neurodevelopmental challenges.
• Effective post-discharge care pathways are crucial for optimizing outcomes in pediatric ECMO survivors.
• The Standardized Therapy after ECMO Program (STEP) was developed to address these needs.

Purpose of the Study:

• To evaluate the compliance with post-ECMO care guidelines after implementing the STEP discharge pathway.
• To assess the impact of STEP on neurodevelopmental testing and specialist referrals for pediatric ECMO survivors.

Main Methods:

• The study compared compliance rates before and after the implementation of the STEP program.
• Data collection included tracking neurodevelopmental testing, inpatient consultations, and outpatient referrals.
• 77 pediatric ECMO survivors discharged from a US hospital were analyzed.

Main Results:

• STEP implementation significantly increased complete neurodevelopmental testing from 38.8% to 74.2%.
• Time-appropriate neurodevelopmental testing increased from 71.4% to 95.6%.
• Referrals for audiology, physical therapy, occupational therapy, and speech-language pathology significantly increased post-STEP.

Conclusions:

• The STEP program effectively enhances compliance with hospital and Extracorporeal Life Support Organization (ELSO) follow-up guidelines.
• Implementing an intentional discharge pathway like STEP leads to more timely and comprehensive neurodevelopmental evaluations for pediatric ECMO survivors.