• Frontiers in pediatrics · Jan 2013

    Neurodevelopmental Outcomes after Pediatric Cardiac ECMO Support.

    • Constantinos Chrysostomou, Timothy Maul, Patrick M Callahan, Khoa Nguyen, Steven Lichtenstein, Emma G Coate, Victor O Morell, and Peter Wearden.
    • Critical Care Medicine, Cardiac Intensive Care, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, PA , USA.
    • Front Pediatr. 2013 Jan 1;1:47.

    PurposeTo characterize the neurodevelopmental outcomes and identify factors associated with poor outcomes in pediatric patients undergoing cardiac extracorporeal membrane oxygenation (ECMO).MethodsFive 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.ResultsOverall ECMO survival was 73% at hospital discharge and 66% a t the latest follow-up. Most patients underwent cardiopulmonary resuscitation (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.ConclusionExtracorporeal membrane oxygenation 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.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…