• Alizée Michel, Meryl Vedrenne-Cloquet, Manoëlle Kossorotoff, Michaël Thy, Raphaël Levy, Marie Pouletty, Charles De Marcellus, Marion Grimaud, Florence Moulin, Marie Hully, Hina Simonnet, Isabelle Desguerre, Sylvain Renolleau, Mehdi Oualha, and Judith Chareyre.
• Réanimation Medico-Chirurgicale Pédiatrique, Hôpital Necker Enfants Malades, Paris, France.
• Pediatr Crit Care Me. 2024 Mar 1; 25 (3): e158e167e158-e167.

RationaleUse of life support with extracorporeal membrane oxygenation (ECMO) is associated with brain injury. However, the consequences of these injuries on subsequent neurologic development and health-related quality of life (HRQoL) are poorly described in children.ObjectivesThe aim of this preliminary study was to describe short- and long-term neurologic outcomes in survivors of ECMO, as well as their HRQoL.DesignRetrospective identified cohort with contemporary evaluations.SettingNecker Children's Hospital academic PICU.PatientsForty survivors who underwent ECMO (October 2014 to January 2020) were included in follow-up assessments in May 2021.InterventionsNone.Measurement And Main ResultsWe first reviewed the outcomes of ECMO at the time of PICU discharge, which included a summary of neurology, radiology, and Pediatric Overall/Cerebral Performance Category (POPC/PCPC) scores. Then, in May 2021, we interviewed parents and patients to assess HRQoL (Pediatric Quality of Life Inventory [PedsQL]) and POPC/PCPC for children 3 years old or older, and Denver II test (DTII) for younger children. An evaluation of DTII in the youngest patients 1 year after ECMO decannulation was also added. Median age at ECMO was 1.4 years (interquartile range [IQR], 0.4-6 yr). Thirty-five children (88%) underwent a venoarterial ECMO. At PICU discharge, 15 of 40 patients (38%) had neurologic impairment. Assessment of HRQoL was carried out at median of 1.6 years (IQR, 0.7-3.3 yr) after PICU discharge. PedsQL scores were over 70 of 100 for all patients (healthy peers mean results: 80/100), and scores were like those published in patients suffering with chronic diseases. In May 2021, seven of 15 patients had a normal DTII, and 36 of 40 patients had a POPC/PCPC score less than or equal to 3.ConclusionsNone of our patients presented severe disability at long term, and HRQoL evaluation was reassuring. Considering the risk of neurologic impairment after ECMO support, a systematic follow-up of these high-risk survivor patients would be advisable.Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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