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Neurodevelopmental outcome after neonatal extracorporeal membrane oxygenation
C M Robertson1, N N Finer, R S Sauve
1Department of Pediatrics, University of Alberta, Edmonton.
Summary
Extracorporeal membrane oxygenation (ECMO) and conventional treatment showed similar neurodevelopmental outcomes in critically ill neonates. Underlying diagnosis, not transport distance, impacts outcomes, supporting early ECMO transfer for respiratory failure.
Area of Science:
- Neonatal care
- Pediatric neurology
- Critical care medicine
Background:
- Critically ill neonates with respiratory failure require advanced life support.
- Extracorporeal membrane oxygenation (ECMO) offers an alternative to conventional therapy.
- Neurodevelopmental outcomes following these treatments require thorough investigation.
Purpose of the Study:
- To compare neurodevelopmental outcomes in neonates treated with ECMO versus conventional therapy.
- To identify factors influencing outcomes, including underlying diagnosis and transport distance.
Main Methods:
- Multicenter prospective longitudinal comparative outcome study.
- Follow-up at 2 years of age for neurodevelopmental disability and Bayley Scales of Infant Development.
- Comparison between ECMO-treated and conventionally treated neonates.
Main Results:
- No statistically significant difference in neurodevelopmental disabilities between ECMO and conventional groups (16% vs 4%).
- Mean mental and performance developmental indexes did not differ significantly between groups.
- Sepsis as an underlying diagnosis was associated with lower Bayley indexes compared to meconium aspiration syndrome in ECMO patients.
Conclusions:
- Neurodevelopmental disability and delay occur in both ECMO and conventional treatment groups.
- Underlying diagnosis significantly affects neurodevelopmental outcomes, while transport distance does not.
- Early transfer for ECMO is supported for neonates with refractory respiratory failure, pending further research.