TY - JOUR
T1 - Neurologic outcomes after extracorporeal membrane oxygenation
T2 - A systematic review
AU - Boyle, Katharine
AU - Felling, Ryan
AU - Yiu, Alvin
AU - Battarjee, Wejdan
AU - Schwartz, Jamie Mc Elrath
AU - Salorio, Cynthia
AU - Bembea, Melania M.
N1 - Funding Information:
Dr. Bembea’s institution received funding from the National Institutes of Health (NIH)/National Institute of Neurological Disorders and Stroke K23NS076674; she received support for article research from the NIH; and she disclosed off-label product use of extracorporeal membrane oxygenation (not U.S. Food and Drug Administration approved for longer than 6 hr). The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: kboyle14@jhmi.edu Copyright © 2018 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Publisher Copyright:
© 2018 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. Unauthorized reproduction of this article is prohibited.
PY - 2018
Y1 - 2018
N2 - Objectives: The goal of this systematic review of the literature was to summarize neurologic outcomes following neonatal and pediatric extracorporeal membrane oxygenation. Data Sources: We conducted electronic searches of PubMed, Scopus, Web of Science, CINAHL, Cochrane, and EMBASE. Study Selection: Inclusion criteria included publication dates 2000-2016, patient ages 0-18 years, and use of standardized measures to evaluate outcomes after extracorporeal membrane oxygenation. Data Extraction: We identified 3,497 unique citations; 60 full-Text articles were included in the final review. Data Synthesis: Studies evaluated patients with congenital diaphragmatic hernia (7), cardiac disease (8), cardiac arrest (13), and mixed populations (32). Follow-up was conducted at hospital discharge in 10 studies (17%) and at a median of 26 months (interquartile range, 8-61 mo) after extracorporeal membrane oxygenation in 50 studies (83%). We found 55 outcome measures that assessed overall health and function (4), global cognitive ability (7), development (4), motor function (5), adaptive function (2), behavior/mood (6), hearing (2), quality of life (2), school achievement (5), speech and language (6), learning and memory (4), and attention and executive function (8). Overall, 10% to as many as 50% of children scored more than 2 sds below the population mean on cognitive testing. Behavior problems were identified in 16-46% of children tested, and severe motor impairment was reported in 12% of children. Quality of life of former extracorporeal membrane oxygenation patients evaluated at school age or adolescence ranged from similar to healthy peers, to 31-53% having scores more than 1 sd below the population mean. Conclusions: This systematic review of the literature suggests that children who have undergone extracorporeal membrane oxygenation suffer from a wide range of disabilities. A meta-Analysis was not feasible due to heterogeneity in pathologies, outcome measures, and age at follow-up, underscoring the importance of developing and employing a core set of outcomes measures in future extracorporeal membrane oxygenation studies. (Pediatr Crit Care Med 2018; 19:760-766).
AB - Objectives: The goal of this systematic review of the literature was to summarize neurologic outcomes following neonatal and pediatric extracorporeal membrane oxygenation. Data Sources: We conducted electronic searches of PubMed, Scopus, Web of Science, CINAHL, Cochrane, and EMBASE. Study Selection: Inclusion criteria included publication dates 2000-2016, patient ages 0-18 years, and use of standardized measures to evaluate outcomes after extracorporeal membrane oxygenation. Data Extraction: We identified 3,497 unique citations; 60 full-Text articles were included in the final review. Data Synthesis: Studies evaluated patients with congenital diaphragmatic hernia (7), cardiac disease (8), cardiac arrest (13), and mixed populations (32). Follow-up was conducted at hospital discharge in 10 studies (17%) and at a median of 26 months (interquartile range, 8-61 mo) after extracorporeal membrane oxygenation in 50 studies (83%). We found 55 outcome measures that assessed overall health and function (4), global cognitive ability (7), development (4), motor function (5), adaptive function (2), behavior/mood (6), hearing (2), quality of life (2), school achievement (5), speech and language (6), learning and memory (4), and attention and executive function (8). Overall, 10% to as many as 50% of children scored more than 2 sds below the population mean on cognitive testing. Behavior problems were identified in 16-46% of children tested, and severe motor impairment was reported in 12% of children. Quality of life of former extracorporeal membrane oxygenation patients evaluated at school age or adolescence ranged from similar to healthy peers, to 31-53% having scores more than 1 sd below the population mean. Conclusions: This systematic review of the literature suggests that children who have undergone extracorporeal membrane oxygenation suffer from a wide range of disabilities. A meta-Analysis was not feasible due to heterogeneity in pathologies, outcome measures, and age at follow-up, underscoring the importance of developing and employing a core set of outcomes measures in future extracorporeal membrane oxygenation studies. (Pediatr Crit Care Med 2018; 19:760-766).
KW - Extracorporeal membrane oxygenation; intensive care unit
KW - Neurocognitive outcomes
KW - Neurodevelopmental outcomes
KW - Pediatric intensive care unit
KW - Pediatrics
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U2 - 10.1097/PCC.0000000000001612
DO - 10.1097/PCC.0000000000001612
M3 - Article
C2 - 29894448
AN - SCOPUS:85056302062
SN - 1529-7535
VL - 19
SP - 760
EP - 766
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 8
ER -