Published online April 24, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. e845-e854 (doi:10.1542/peds.2005-1167)

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United Kingdom Collaborative Randomized Trial of Neonatal Extracorporeal Membrane Oxygenation: Follow-up to Age 7 Years

Helena McNally, MSc^a, Charlotte C. Bennett, MD^b, Diana Elbourne, PhD^c, David J. Field, MD^d for the UK Collaborative ECMO Trial Group

^a Medical Sciences Division, University of Oxford
^b Neonatal Unit, John Radcliffe Hospital, Oxford, United Kingdom
^c Medical Statistics Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
^d Neonatal Unit, Leicester Royal Infirmary, Leicester, United Kingdom

OBJECTIVE. The UK Collaborative ECMO trial provided an opportunity to describe mortality and morbidity associated with a neonatal ECMO policy compared with conventional management. The improved survival in the ECMO group was not offset by an increase in disability at 4 years, but the children were too young to assess educational and other longer-term impacts. The objective of this study was to assess the longer-term impact of these policies at age 7 years.

METHODS. A psychologist assessed 90 of the 100 children available for follow-up without prior knowledge of treatment allocation. The assessments took place at the children's schools within 3 months of their 7th birthdays.

RESULTS. Sixty-eight of 89 (76%) children recorded a cognitive level within the normal range. Learning problems were similar in the 2 groups, and there were notable difficulties with spatial and processing tasks. A higher respiratory morbidity and increased risk of behavioral problems among children treated conventionally persisted. Progressive sensorineural hearing loss was found in both groups.

CONCLUSIONS. The underlying disease processes appear to be the major influence on morbidity at 7 years. The beneficial influence of an ECMO policy is still present at 7 years.

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Key Words: follow-up studies • respiratory distress • neonatal care • long-term survival • long-term follow-up

Abbreviations: CI—confidence interval • BAS—British Ability Scales 195 • GCAS—General Conceptual Ability Score • MABC—Movement Assessment Battery for Children • SD—standard deviation • SDQ—Strengths and Difficulties Questionnaire • SNHL—sensorineural hearing loss

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Accepted Nov 7, 2005.

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