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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

Figure 1
Figure 1
Systematic Review Flowsheet
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References

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