PMID- 19341476
OWN - NLM
STAT- MEDLINE
DCOM- 20090908
LR  - 20211020
IS  - 1466-609X (Electronic)
IS  - 1364-8535 (Print)
IS  - 1364-8535 (Linking)
VI  - 13
IP  - 2
DP  - 2009
TI  - Motor performance in five-year-old extracorporeal membrane oxygenation survivors: 
      a population-based study.
PG  - R47
LID - 10.1186/cc7770 [doi]
AB  - INTRODUCTION: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a 
      cardio-pulmonary bypass technique to provide life support in acute reversible 
      cardio-respiratory failure when conventional management is not successful. Most 
      neonates receiving ECMO suffer from meconium aspiration syndrome (MAS), 
      congenital diaphragmatic hernia (CDH), sepsis or persistent pulmonary 
      hypertension (PPH). In five-year-old children who underwent VA-ECMO therapy as 
      neonates, we assessed motor performance related to growth, intelligence and 
      behaviour, and the association with the primary diagnosis. METHODS: In a 
      prospective population-based study (n = 224) 174 five-year-old survivors born 
      between 1993 and 2000 and treated in the two designated ECMO centres in the 
      Netherlands (Radboud University Medical Centre Nijmegen and Sophia Children's 
      Hospital, Erasmus MC - University Medical Center Rotterdam) were invited to 
      undergo follow-up assessment including a paediatric assessment, the movement 
      assessment battery for children (MABC), the revised Amsterdam intelligence test 
      (RAKIT) and the child behaviour checklist (CBCL). RESULTS: Twenty-two percent of 
      the children died before the age of five, 86% (n = 149) of the survivors were 
      assessed. Normal development in all domains was found in 49% of children. Severe 
      disabilities were present in 13%, and another 9% had impaired motor development 
      combined with cognitive and/or behavioural problems. Chi-squared tests showed 
      adverse outcome in MABC scores (P < 0.001) compared with the reference population 
      in children with CDH, sepsis and PPH, but not in children with MAS. Compared with 
      the Dutch population height, body mass index (BMI) and weight for height were 
      lower in the CDH group (P < 0.001). RAKIT and CBCL scores did not differ from the 
      reference population. Total MABC scores, socio-economic status, growth and CBCL 
      scores were not related to each other, but negative motor outcome was related to 
      lower intelligence quotient (IQ) scores (r = 0.48, P < 0.001). CONCLUSIONS: The 
      ECMO population is highly at risk for developmental problems, most prominently in 
      the motor domain. Adverse outcome differs between the primary diagnosis groups. 
      Objective evaluation of long-term developmental problems associated with this 
      highly invasive technology is necessary to determine best evidence-based 
      practice. The ideal follow-up programme requires an interdisciplinary team, the 
      use of normal-referenced tests and an international consensus on timing and 
      actual outcome measurements.
FAU - Nijhuis-van der Sanden, Maria W G
AU  - Nijhuis-van der Sanden MW
AD  - Department of Paediatric Physical Therapy and Scientific Institute for Quality of 
      Healthcare, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 
      10, 6525 GA Nijmegen, The Netherlands. r.nijhuis@cukz.umcn.nl
FAU - van der Cammen-van Zijp, Monique H M
AU  - van der Cammen-van Zijp MH
FAU - Janssen, Anjo J W M
AU  - Janssen AJ
FAU - Reuser, Jolanda J C M
AU  - Reuser JJ
FAU - Mazer, Petra
AU  - Mazer P
FAU - van Heijst, Arno F J
AU  - van Heijst AF
FAU - Gischler, Saskia J
AU  - Gischler SJ
FAU - Tibboel, Dick
AU  - Tibboel D
FAU - Kollee, Louis A A
AU  - Kollee LA
LA  - eng
PT  - Journal Article
DEP - 20090402
PL  - England
TA  - Crit Care
JT  - Critical care (London, England)
JID - 9801902
SB  - IM
MH  - Chi-Square Distribution
MH  - Child Development
MH  - Child, Preschool
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - Follow-Up Studies
MH  - Health Status
MH  - Humans
MH  - Infant, Newborn
MH  - Male
MH  - Netherlands
MH  - *Psychomotor Performance
MH  - Social Class
MH  - Surveys and Questionnaires
MH  - *Survivors
PMC - PMC2689491
EDAT- 2009/04/04 09:00
MHDA- 2009/09/09 06:00
PMCR- 2009/04/02
CRDT- 2009/04/04 09:00
PHST- 2009/01/02 00:00 [received]
PHST- 2009/02/27 00:00 [revised]
PHST- 2009/04/02 00:00 [accepted]
PHST- 2009/04/04 09:00 [entrez]
PHST- 2009/04/04 09:00 [pubmed]
PHST- 2009/09/09 06:00 [medline]
PHST- 2009/04/02 00:00 [pmc-release]
AID - cc7770 [pii]
AID - 10.1186/cc7770 [doi]
PST - ppublish
SO  - Crit Care. 2009;13(2):R47. doi: 10.1186/cc7770. Epub 2009 Apr 2.