Neurodevelopmental outcome and respiratory morbidity for extracorporeal membrane oxygenation survivors at 1 year of age

Abstract

Outcome at 1 year was evaluated in 37 neonates treated with extracorporeal membrane oxygenation (ECMO) between June 1987 and March 1989. Thirty of 37 survived, and 7 of 30 showed major abnormalities in respiratory status, neurologic examination, or developmental status. Abnormal respiratory status was defined as need for supplemental oxygen, tracheostomy, or mechanical ventilation, and developmental delay was defined as developmental quotient < 70 on either the Mental or Psychomotor scale of the Bayley Scales of Infant Development. Five of seven children with major abnormalities were affected in more than one system. Adverse outcome was associated with the presence of congenital anomalies. Perinatal factors including Apgar scores, last pH before starting extracorporeal membrane oxygenation, and number of hours on ECMO did not show a significant correlation with Bayley scores. Computed tomography and electroencephalography of neonates showed no relationship to Bayley scores or neurologic examination. In conclusion, a small subgroup of patients accounts for the majority of abnormal findings at 1 year, and the presence of congenital anomalies appears to increase the risk for abnormal outcome.