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. 2018 Aug;19(8):760-766.
doi: 10.1097/PCC.0000000000001612.

Neurologic Outcomes After Extracorporeal Membrane Oxygenation: A Systematic Review

Katharine Boyle  1 , Ryan Felling  2 , Alvin Yiu  1 , Wejdan Battarjee  1 , Jamie McElrath Schwartz  1   3 , Cynthia Salorio  4 , Melania M Bembea  1   3
Affiliations

Neurologic Outcomes After Extracorporeal Membrane Oxygenation: A Systematic Review

Katharine Boyle et al. Pediatr Crit Care Med. 2018 Aug.

Abstract

Objectives: The goal of this systematic review of the literature was to summarize neurologic outcomes following neonatal and pediatric extracorporeal membrane oxygenation.

Data sources: We conducted electronic searches of PubMed, Scopus, Web of Science, CINAHL, Cochrane, and EMBASE.

Study selection: Inclusion criteria included publication dates 2000-2016, patient ages 0-18 years, and use of standardized measures to evaluate outcomes after extracorporeal membrane oxygenation.

Data extraction: We identified 3,497 unique citations; 60 full-text articles were included in the final review.

Data synthesis: Studies evaluated patients with congenital diaphragmatic hernia (7), cardiac disease (8), cardiac arrest (13), and mixed populations (32). Follow-up was conducted at hospital discharge in 10 studies (17%) and at a median of 26 months (interquartile range, 8-61 mo) after extracorporeal membrane oxygenation in 50 studies (83%). We found 55 outcome measures that assessed overall health and function (4), global cognitive ability (7), development (4), motor function (5), adaptive function (2), behavior/mood (6), hearing (2), quality of life (2), school achievement (5), speech and language (6), learning and memory (4), and attention and executive function (8). Overall, 10% to as many as 50% of children scored more than 2 SDS below the population mean on cognitive testing. Behavior problems were identified in 16-46% of children tested, and severe motor impairment was reported in 12% of children. Quality of life of former extracorporeal membrane oxygenation patients evaluated at school age or adolescence ranged from similar to healthy peers, to 31-53% having scores more than 1 SD below the population mean.

Conclusions: This systematic review of the literature suggests that children who have undergone extracorporeal membrane oxygenation suffer from a wide range of disabilities. A meta-analysis was not feasible due to heterogeneity in pathologies, outcome measures, and age at follow-up, underscoring the importance of developing and employing a core set of outcomes measures in future extracorporeal membrane oxygenation studies.

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Conflict of interest statement

The remaining authors have disclosed that they do not have any potential conflicts of interest.

Figures

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Figure 1
Systematic Review Flowsheet
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References

    1. Barbaro RP, Paden ML, Guner YS, et al. Asaio Journal. Publish Ahead of Print; 2017. Pediatric extracorporeal life support organization registry international report 2016. - PMC - PubMed
    1. Thiagarajan RR, Barbaro RP, Rycus PT, et al. Extracorporeal life support organization registry international report 2016. ASAIO J. 2017;63:60–67. - PubMed
    1. Extracorporeal Life Support Organization. Extracorporeal life support organization registry international summary. 2017
    1. Cengiz P, Seidel K, Rycus PT, et al. Central nervous system complications during pediatric extracorporeal life support: Incidence and risk factors*. Crit Care Med. 2005;33:2817–2824. - PubMed
    1. McNally H, Bennett CC, Elbourne D, et al. United kingdom collaborative randomized trial of neonatal extracorporeal membrane oxygenation: Follow-up to age 7 years. Pediatrics. 2006;117:e854. - PubMed

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