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Neurodevelopmental, educational and behavioral outcome at 8 years after neonatal ECMO: a nationwide multicenter study

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Abstract

Purpose

Reporting neurodevelopmental outcome of 8-year-old children treated with neonatal extracorporeal membrane oxygenation (ECMO).

Methods

In a follow-up study in 135 8-year-old children who received neonatal ECMO between 1996 and 2001 we assessed intelligence (Revised Amsterdam Intelligence Test), concentration (Bourdon-Vos test), eye-hand coordination (Developmental Test of Visual-Motor Integration) and behavior (Child Behavior Checklist and Teacher Report Form).

Results

Intelligence fell within normal range (mean IQ 99.9, SD 17.7, n = 125) with 91 % of the children following regular education. Significantly more children attended special education (9 %) or received extra support in regular education (39 %) compared with normative data. Slower working speed (χ2 = 132.36, p < 0.001) and less accuracy (χ2 = 12.90, p < 0.001) were found on the Bourdon-Vos test (n = 123) compared with normative data. Eye-hand coordination fell within the normal range (mean 97.6, SD 14.3, n = 126); children with congenital diaphragmatic hernia scored lowest but still normally (mean 91.0, SD 16.4, n = 28). Mothers (n = 117) indicated more somatic and attention behavior problems; teachers (n = 115) indicated more somatic, social, thought, aggression and total problems compared with normative data. Mothers indicated more somatic problems than teachers (p = 0.003); teachers reported more attention problems than mothers (p = 0.036; n = 111).

Conclusions

Eight-year-old children treated with neonatal ECMO fall in the normal range of intelligence with problems with concentration and behavior. Long-term follow-up for children treated with neonatal ECMO should focus on early detection of (subtle) learning deficits.

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Acknowledgments

This article was written on behalf of the Dutch national ECMO follow-up team, consisting of pediatricians, developmental psychologists, speech-language pathologists and pediatric physiotherapists in both centers. The authors thank the entire team and specifically the ones not mentioned in the author list: Marjolein Spoel (physician), Monique van der Cammen- van Zijp (physiotherapist), Anne Zirar-Vroegindeweij and Annabel van Gils-Frijters (developmental psychologists) from Erasmus MC- Sophia Children’s Hospital and Anjo Janssen (physiotherapist) and Sandra de Groot (speech-language pathologist) from Radboud University Nijmegen Medical Center for their contribution to this study. Ko Hagoort provided editorial advice. Financial support was provided by the Swart-van Essen Fund.

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Intensive Care and Department of Paediatric Surgery, Erasmus Medical Center-Sophia Children’s Hospital, Room Sk 1280; dr. Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands

    Marlous J. Madderom, Saskia J. Gischler, Dick Tibboel & Hanneke IJsselstijn

  2. Department of Medical Psychology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Jolanda J. C. M. Reuser

  3. Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam, The Netherlands

    Elisabeth M. W. J. Utens

  4. Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands

    Joost van Rosmalen

  5. Department of Neonatology, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam, The Netherlands

    Marlou Raets & Paul Govaert

  6. Department of Neonatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Katerina Steiner & Arno F. J. van Heijst

Authors
  1. Marlous J. Madderom
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  2. Jolanda J. C. M. Reuser
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  3. Elisabeth M. W. J. Utens
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  4. Joost van Rosmalen
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  5. Marlou Raets
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  6. Paul Govaert
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  7. Katerina Steiner
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  8. Saskia J. Gischler
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  9. Dick Tibboel
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  10. Arno F. J. van Heijst
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  11. Hanneke IJsselstijn
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Corresponding author

Correspondence to Hanneke IJsselstijn.

Additional information

On behalf of the Dutch ECMO follow-up team.

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Madderom, M.J., Reuser, J.J.C.M., Utens, E.M.W.J. et al. Neurodevelopmental, educational and behavioral outcome at 8 years after neonatal ECMO: a nationwide multicenter study. Intensive Care Med 39, 1584–1593 (2013). https://doi.org/10.1007/s00134-013-2973-1

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  • DOI: https://doi.org/10.1007/s00134-013-2973-1

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