Abstract
Objective: The infants who received extracorporeal membrane oxygenation (ECMO) support in the neonatal period may have life-long developmental risks. The objective of this study was to determine the developmental risk factors and developmental status at the 1st and 2nd year follow-up evaluations of the infants who were supported with ECMO in the neonatal period at Ankara University (AU) Neonatal Intensive Care Unit (NICU).
Material and Methods: Infants in this research were evaluated with the information of perinatal risk factors, neonatal intensive care unit progress and the evaluations with the Expanded-Guide for Monitoring Child Development (Exp- GMCD), Guide for Monitoring Child Development (GMCD), and the Bayley Scales of Infant Development-III (BSID-III).
Results: The sample consisted of 8 babies who survived from 12 newborns who received ECMO support at AU NICU between September 2015 and September 2017. One of the babies with Down syndrome had significant developmental delays in the language, cognitive, fine and gross motor domains at 1st and 2nd year follow-up and another baby had an expressive language delay at the 2nd year evaluation.
Conclusion: According to the developmental assessment of the infants who received ECMO support at the AU NICU, 75% (6 cases) were developed age-appropriately in all developmental domains with standardized tools. It is important to monitor the development of these children with a transdiciplinary approach to determine risk factors, support early childhood development and the family, and provide early diagnosis and intervention.
Keywords: ECMO, Development, Developmental difficulty
References
- 1.Mok YH, Lee JH, Cheifetz IM. Neonatal extracorporeal membrane
- oxygenation: Update on management strategies and long-term
- outcomes. Advances in Neonatal Care 2016;16:26–36.
- 2. Bartlett RH. Esperanza: Presidential address. Trans Am Soc Artif
- Intern Organs 1985;31:723-6.
- 3. The Extracorporeal Life Support Organization (ELSO). ECLS
- Registry Report, International Summary, January 2017. Ann Arbor,
- MI: Extracorporeal Life Support Organization; 2017.
- 4. Ijsselstijn H, van Heijst AF. Long-term outcome of children treated
- with neonatal extracorporeal membrane oxygenation: Increasing
- problems with increasing age. Semin Perinatol 2014;38:114-21.
- 5. Engle WA, West KW, Hocutt GA, Pallotto EK, Haney B, Keith RJ,
- et al. Adult outcomes after newborn respiratory failure treated
- with extracorporeal membrane oxygenation. Pediatr Crit Care Med
- 2017;18:73-9.
- 6. Davis DW. Long-term follow-up of survivors of neonatal ECMO:
- What do we really know? Pediatr Nurs 1998;24:343-7.
- 7. Ahmad A, Gangitano E, Odell RM, Doran R, Durand M. Survival,
- intracranial lesions, and neurodevelopmental outcome in infants
- with congenital diaphragmatic hernia treated with extracorporeal
- membrane oxygenation. J Perinatol 1999;19(6 Pt 1):436-40.
- 8. Parish AP, Bunyapen C, Cohen MJ, Garrison T, Bhatia J. Seizures
- as a predictor of long-term neurodevelopmental outcome in
- survivors of neonatal extracorporeal membrane oxygenation
- (ECMO). J Child Neurol 2004;19:930-4.
- 9. Schiller RM, Madderom MJ, Reuser JJ, Steiner K, Gischler SJ,
- Tibboel D, et al. Neuropsychological follow-up after neonatal
- ECMO. Pediatrics 2016;138(5). pii: e20161313.
- 10. Madderom MJ, Reuser JJCM, Utens EM, van Rosmalen J,
- Raets M, Govaert P, et al. Neurodevelopmental, educational and
- behavioral outcome at 8 years after neonatal ECMO: A nationwide
- multicenter study. Intensive Care Med 2013;39:1584-93.
- 11. Gedik E, Atar F, Ozdemirkan A, Camkiran Firat A, Zeyneloglu
- P, Sezgin A, Pirat A. Perioperative venoarterial extracorporeal
- membrane oxygenation support during heart transplant. Exp Clin
- Transplant 2017;15:224-30.
- 12. Erek E, Aydın S, Suzan D, Yıldız O, Altın F, Kırat B, et al.
- Extracorporeal cardiopulmonary resuscitation for refractory
- cardiac arrest in children after cardiac surgery. Anatol J Cardiol
- 2017;17:328-33.
- 13. Öztürk MN, Ak K, Erkek N, Yeşil E, Duyu M, Yazici P, et al. Early
- extracorporeal life support experiences in 2 tertiary pediatric
- intensive care units in Turkey. Turk J Med Sci 2014;44:769-74.
- 14. Okulu E, Atasay FB, Tunç G, Akduman H, Erdeve Ö, Arsan S, et
- al. Extracorporeal membrane oxygenation support in neonates:
- A single center experience in Turkey. Turk J Med Sci, in press.
- doi:10.3906/sag-1707-62.
- 15. Bronfenbrenner U. Ecological models of human development. In:
- International Encyclopedia of Education, Volume 3, 2nd ed. Oxford:
- Elsevier. Reprinted in: Gauvain, M & Cole M (eds) Readings on the
- development of children. 2nd ed. New York: Freeman, 1993:37-
- 43.
- 16. World Health Organization, The International Classification of
- Functioning, Disability and Health (ICF). Geneva: WHO, 2001.
- 17. Galip N. Gelişimi İzleme ve Destekleme Rehberi”nin “Dünya
- Sağlık Örgütü (DSÖ) İşlevsellik, Yetiyitimi ve Sağlığın Uluslararası
- Sınıflandırması (ICF-CY)” na Uyarlanması ve 0–5 Yaş Arası
- Kronik Hastalığı Olan Çocukların Değerlendirilmesinde Geçerliliği.
- Yayınlanmamış Uzmanlık Tezi, Ankara Üniversitesi Tıp Fakültesi,
- Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Ankara, Türkiye, 2009.
- 18. Ertem IO, Krishnamurthy V, Mulaudzi MC, Sguassero Y, Balta H,
- Gulumser O, et al. Similarities and differences in child development
- from birth to age 3 years by sex and across four countries: A crosssectional,
- observational study. Lancet Glob Health 2018;6:e279-
- 91.
- 19. Bayley N. Bayley Scales of Infant and Toddler Development:
- Administration Manual. 3rd ed. San Antonio: Psychological
- Corporation, 2006.
- 20. SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for
- Windows, Version 21.0. Armonk, NY: IBM Corp.
- 21. Bernbaum J, Schwartz IP, Gerdes M, D’Agostino JA, Coburn CE,
- Polin RA. Survivors of extra corporeal membrane oxygenation at 1
- year of age: The relationship of primary diagnosis with health and
- neurodevelopmental sequelae. Pediatrics. 1995;96:907–13.
- 22. Robertson CM, Finer NN, Sauve RS, Whitfield MF, Belgaumkar
- TK, Synnes AR, et al. Neurodevelopmental outcome after neonatal
- extracorporeal membrane oxygenation. CMAJ 1995;152:1981-8.
- 23. The collaborative UKECMO (Extracorporeal Membrane Oxygenation)
- trial: Follow-up to 1 year of age. Pediatrics 1998;101:E1.
- 24. Macrae DJ, Field DJ. Our study 20 years on: UK Collaborative
- randomised trial of neonatal extracorporeal membrane oxygenation.
- Intensive Care Med 2016;42:841-3
- .
- 25. Khambekar K, Nichani S, Luyt DK, Peek G, Firmin RK, Field DJ,
- et al. Developmental outcome in newborn infants treated for acute
- respiratory failure with extra corporeal membrane oxygenation:
- Present experience. Arch Dis Child Fetal Neonatal Ed 2006;91:F21–
- 5.
- 26. Flamant C, Lorino E, Nolent P, Hallalel F, Chevalier JY, Fau S, et
- al. Newborn infants supported by extracorporeal membrane
- oxygenation: Survival and clinical outcome. Arch Pediatr
- 2007;14:354-61.
- 27. Bennett CC, Johnson A, Field DJ, Elbourne D, Group UKCET
- U.K. Collaborative randomised trial of neonatal extracorporeal
- membrane oxygenation: Follow-up to age 4 years. Lancet
- 2001;357:1094–6.
- 28. Wien MA, Whitehead MT, Bulas D, Ridore M, Melbourne L,
- Oldenburg G, et al. Patterns of brain ınjury in newborns treated with
- extracorporeal membrane oxygenation. AJNR Am J Neuroradiol
- 2017;38:820-6.
- 29. Cashen K, Thiagarajan RR, Collins JW Jr, Rycus PT, Backer CL,
- Reynolds M, et al. Extracorporeal membrane oxygenation in
- pediatric trisomy 21: 30 years of experience from the extracorporeal
- life support organization registry. J Pediatr 2015;167:403-8.