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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2013
Congenital diaphragmatic hernia with(out) ECMO: impaired development at 8 years.
- Marlous J Madderom, Leontien Toussaint, Monique H M van der Cammen-van Zijp, Saskia J Gischler, René M H Wijnen, Dick Tibboel, and Hanneke Ijsselstijn.
- Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Dr. Molewaterplein 60; Rotterdam, The Netherlands.
- Arch. Dis. Child. Fetal Neonatal Ed. 2013 Jul 1;98(4):F316-22.
ObjectiveTo evaluate developmental and social-emotional outcomes at 8 years of age for children with congenital diaphragmatic hernia (CDH), treated with or without neonatal extracorporeal membrane oxygenation (ECMO) between January 1999 and December 2003.DesignCohort study with structural prospective follow-up.SettingLevel III University Hospital.Patients35 children (ECMO: n=16; non-ECMO: n=19) were assessed at 8 years of age.InterventionsNone.Main Outcome MeasuresIntelligence and motor function. Concentration, behaviour, school performance, competence and health status were also analysed.ResultsMean (SD) intelligence for the ECMO group was 91.7 (19.5) versus 111.6 (20.9) for the non-ECMO group (p=0.015). Motor problems were apparent in 16% of all participants and differed significantly from the norm (p=0.015) without differences between treatment groups. For all participants, problems with concentration (68%, p<0.001) and with behavioural attention (33%, p=0.021) occurred more frequently than in reference groups, with no difference between treatment groups. School performance and competence were not affected.ConclusionsChildren with CDH-whether or not treated with neonatal ECMO-are at risk for long-term morbidity especially in the areas of motor function and concentration. Despite their impairment, children with CDH have a well-developed feeling of self-competence.
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