The Vulnerable Brain : neurodevelopment after neonatal critical illness

Over the last decade, the number of children admitted to specialized intensive care units has increased significantly worldwide. The majority of critically ill infants nowadays survive. This development requires our focus to broaden from minimizing mortality rates to maximizing long-term quality of life following neonatal critical illness.

In this thesis we describe long-term neuropsychological outcome and the brain following treatment with neonatal extracorporeal membrane oxygenation (ECMO) and/or congenital diaphragmatic hernia (CDH). Based on our findings, we propose a common neurodevelopmental pathway across survivors of neonatal critical illness, in which early hippocampal alterations are associated with long-term memory deficits, irrespective of underlying disease or gestational age. We also report the results from a nationwide, randomized controlled trial assessing the effects of Cogmed Working Memory Training on neuropsychological outcome and the brain in neonatal ECMO and/or CDH survivors.

The findings presented in this thesis demonstrate the importance of long-term neurodevelopmental follow-up in survivors of neonatal critical illness and stress the need for early risk stratification and targeted intervention strategies for these children.