Article: Neurologic Outcomes and Quality of Life in Children After Extracorporeal Membrane Oxygenation.
2023 Volume 25, Issue 3, Page(s) e158–e167
Abstract: Rationale: Use 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 ... ...
| Abstract | Rationale: Use 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. Objectives: The aim of this preliminary study was to describe short- and long-term neurologic outcomes in survivors of ECMO, as well as their HRQoL. Design: Retrospective identified cohort with contemporary evaluations. Setting: Necker Children's Hospital academic PICU. Patients: Forty survivors who underwent ECMO (October 2014 to January 2020) were included in follow-up assessments in May 2021. Interventions: None. Measurement and main results: We 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. Conclusions: None 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. |
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| MeSH term(s) | Child ; Humans ; Infant ; Child, Preschool ; Quality of Life ; Extracorporeal Membrane Oxygenation/adverse effects ; Retrospective Studies ; Health Status ; Nervous System Diseases/epidemiology ; Nervous System Diseases/etiology |
| Language | English |
| Publishing date | 2023-12-13 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2052349-X |
| ISSN | 1947-3893 ; 1529-7535 |
| ISSN (online) | 1947-3893 |
| ISSN | 1529-7535 |
| DOI | 10.1097/PCC.0000000000003419 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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