ORIGINAL ARTICLE

Developmental outcome in newborn infants treated for acute respiratory failure with extracorporeal membrane oxygenation: present experience

K Khambekar¹, S Nichani², D K Luyt², G Peek², R K Firmin², D J Field¹ and H C Pandya²

¹ Department of Neonataology, University Hospitals Leicester, Leicester, UK
² Department of ECMO and Paediatric Intensive Care, University Hospitals Leicester

Correspondence to:
Correspondence to:
Dr Pandya
Department of ECMO and Paediatric Intensive Care, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK; hp28{at}le.ac.uk

Objective: To describe the later health status of newborn infants who received extracorporeal membrane oxygenation (ECMO) for acute respiratory failure in the era after the UK ECMO trial.

Design: Prospective follow up study of newborn infants who received ECMO at a single centre between January 1997 and January 2001.

Setting: Departments of ECMO and Paediatric Intensive Care, University Hospitals of Leicester.

Patients: All babies who received ECMO within 14 days of birth.

Interventions: Neurodevelopment screening using the schedule for growing skills-II (SGS-II) assessment tool.

Main outcome measures: Survival at 12 months of age by disease and functional development at follow up.

Results: A total of 145 neonates received ECMO for treatment of respiratory failure. Of these, 108 (75%) were alive at 1 year of age. There were no deaths in children treated for respiratory failure secondary to meconium aspiration syndrome (73/145). Ninety three (86% of survivors) infants attended a follow up visit at 11–19 months postnatal age. Eighty two were classed as normal, seven as having "impairment", and four as having "severe disability".

Conclusions: Most newborn infants with acute respiratory failure treated with ECMO will have a normal neurodevelopment screening assessment at 11–19 months of postnatal age. There is no evidence to suggest that changes in neonatal practice since the UK ECMO trial have led to changes in outcome of infants undergoing ECMO therapy.

Abbreviations: CDH, congenital diaphragmatic hernia; DQ, developmental quotient; ECMO, extracorporeal membrane oxygenation; HFOV, high frequency oscillatory ventilation; iNO, inhaled nitric oxide; MAS, meconium aspiration syndrome; OI, oxygenation index; PPHN, persistent pulmonary hypertension of the newborn; SGS-II, schedule for growing skills-II

Keywords: development; outcome; respiratory; extracorporeal membrane oygenation; lung

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Karimova, A, Brown, K, Ridout, D, Beierlein, W, Cassidy, J, Smith, J, Pandya, H, Firmin, R, Liddell, M, Davis, C, Goldman, A (2009). Neonatal extracorporeal membrane oxygenation: practice patterns and predictors of outcome in the UK. Arch. Dis. Child. Fetal Neonatal Ed. 94: F129-F132 [Abstract] [Full Text]  
• Buesing, K. A., Kilian, A. K., Schaible, T., Loff, S., Sumargo, S., Neff, K. W. (2007). Extracorporeal Membrane Oxygenation in Infants with Congenital Diaphragmatic Hernia: Follow-Up MRI Evaluating Carotid Artery Reocclusion and Neurologic Outcome. Am. J. Roentgenol. 188: 1636-1642 [Abstract] [Full Text]