PEDIATRICS Vol. 83 No. 1 January 1989, pp. 72-78
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Morbidity for Survivors of Extracorporeal Membrane Oxygenation: Neurodevelopmental Outcome at 1 Year of Age

Penny Glass PhD1, Marilea Miller MD1, and Billie Short MD1

1 The Department of Neonatology, Children's Hospital National Medical Center, Washington, DC

Extracorporeal membrane oxygenation is an important technology in the treatment of high-risk infants whose long-term outcome is being followed prospectively at our institution. The extracorporeal membrane oxygenation procedure allows temporary cardiopulmonary support for critically ill full-term neonates who are refractory to maximum ventilatory and medical management as a consequence of severe persistent pulmonary hypertension. The technique necessitates both the permanent ligation of the right common carotid artery and jugular vein and systemic heparinization. The survivors constitute a unique group of high-risk infants, from the standpoint of the hypoxic-ischemic insults preceding extracorporeal membrane oxygenation and the risks associated with the procedure. Our results indicate that most of our survivors are developing normally at 1 year. Major morbidity, in terms of either significant developmental delay (Bayley mental and motor indices less than 70) or significant neuromotor abnormality, occurred in only 10% of these infants. Poor outcome was associated with major intracranial hemorrhage and chronic lung disease. Ligation of the right carotid artery and jugular vein was not associated with a consistent lateralizing lesion. Long-term follow-up through school age is essential.

Key Words: extracorporeal membrane oxygenation • asphyxia • persistent pulmonary hypertension

Submitted on July 8, 1987
Accepted on February 8, 1988




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