neurodevelopmental outcomes after pediatric cardiac ecmo support
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2013
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Abstract
Purpose: To characterize the neurodevelopmental outcomes and identify factors associated with poor outcomes in pediatric patients undergoing cardiac extracorporeal membrane oxygenation (ECMO). Methods: Five year retrospective review, including demographics, cardiac lesion and surgical complexity, reason for ECMO, ECMO complications, and neurodevelopmental status at discharge and latest follow-up. Neurodevelopmental status was determined through the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scales.Results: Overall ECMO survival was 73% at hospital discharge and 66% a t the latest follow-up. Most patients underwent CPR (43%), and the majority (53%) had a significant disease complexity (Aristotle=4). Complications occurred in 42% of the ECMO runs, of which 12% were intracranial injuries. At hospital discharge, 75% of patients had normal to mild disability, improving to 81% at 2 years follow-up. At hospital discharge, moderate to severe disability was associated with CPR, plasma exchange or intracranial insults. After discharge, 23% showed improvement in neurologic status and 4% showed deterioration. Cerebral infarction was the only parameter associated with deterioration at the later follow-up stage.Conclusions: ECMO was successfully used in children with cardiac disease with 73% and 66% short and long-term survival respectively. Majority of the survivors had normal to mild neurodevelopmental disability and a significant portion showed neurologic improvement by the latest follow-up. Nevertheless, despite the grossly favorable outcomes standardized comprehensive neuropsychological testing is of paramount importance in all these patients.
| Reference Key |
echrysostomou2013frontiersneurodevelopmental
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|---|---|
| Authors | ;Constantinos eChrysostomou;Timothy eMaul;Victor O Morell;Patrick M Callahan;Khoa eNguyen;Steven eLichtenstein;Emma G Coate;Peter eWearden |
| Journal | disease markers |
| Year | 2013 |
| DOI |
10.3389/fped.2013.00047
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| URL | |
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