Neurodevelopmental Outcomes After Neonatal and Pediatric ECMO

Abstract

Neonatal and pediatric extracorporeal membrane oxygenation (ECMO) is an increasingly utilized, potentially life-saving therapy for critically ill patients. The immediate and long-term neurodevelopmental outcomes for patients who require ECMO is not fully understood or appreciated. There is a growing body of literature examining the neurodevelopmental outcomes of neonatal and pediatric survivors of ECMO. Estimates of ECMO patients’ long-term neurological disabilities range from 10 to 60% (Glass et al. Pediatrics 83:72–78, 1989; Boyle et al. Pediatr Crit Care Med 19:760–766, 2018). Multiple modalities of neurologic monitoring while on ECMO are being investigated for their ability to detect neurologic injury, but their impact on long-term neurodevelopmental outcome remains unknown. Improved knowledge about the long-term neurodevelopmental outcomes for patients receiving ECMO therapy may help providers to access better resources and support patients after recovery from their acute illnesses. This review seeks to highlight some of the current understanding of the risks for poor neurodevelopmental outcomes of patients supported on ECMO, modes of neurologic monitoring, and recent data on neurodevelopmental outcomes.