Abstract
Back~,round. Extracorporeal membrane oxygenation (ECMO) is a technology that utilizes cardiopulmonary bypass to treat newborn infants with severe respiratory failure. The most serious complication of ECMO is the occurrence of intraeranial hemorrhage or ischemic stroke. This study was performed to compare the long term developmental outcome associated with these two types of perinatal brain injury after ECMO. Methods. Cognitive and motor skills were assessed using the Bayley Scales of Infant Development at 2 years of age (MDI= Mental Developmental Index, PDI=Psyehomotor Developmental Index). The Peabody Infant Motor Scales (DMQ=Developmental Motor Quotien0 was used to further evaluate gross motor (GM) and fine motor (FM) skills. (All scores: mean=100+_SD= 15) Results. 71 infants treated with ECMO over a five year period were evaluated at 2 years of age. 15% of these infants had some type of intracranial hemorrhage or ischemic stroke. Infants with a hemorrhage did not differ significantly in cognitive skills (MDI--89+ 16 versus 91• or motor skills (PDI--92• versus 86-2.17) from those infants without a hemorrhage or infarction. However, infants with an ischemic stroke had significantly lower scores than those infants without an infarction (MDI=63+16 versus 90• PDI=58• versus 87+17; p<.001 for both). Both gross and fine motor skills were severely delayed in these children (DMQ-GM= 48-&36 versus 88_-t.15, DMQ-FM=46+ 28 versus 75+12; p<.001 for both). Conclusions. These data indicate than an intraeranial hemorrhage alone does not necessarily predict poor cognitive or motor outcome in infants treated with ECMO. An ischemic stroke, however, is associated with poor developmental outcome. Improved bedside monitoring of cerebral blood flow and oxygen delivery is needed to be able to detect when ischemie damage is occurring during treatment with ECMO.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call