Long-term Follow-up of Children Treated with Neonatal Extracorporeal Membrane Oxygenation: neuropsychological outcome

This thesis aims to describe the long-term neuropsychological outcome of children and adolescents treated with neonatal extracorporeal membrane oxygenation (ECMO). ECMO is a pulmonary bypass technique providing temporary life support in potentially acute reversible (cardio)respiratory failure when conventional management fails. Bypass allows the lungs to recover without the damaging effects of ongoing mechanical ventilation with high inspired oxygen and peak pressure. It may also prevent further injury from high oxygen concentration, volutrauma and barotrauma1. ECMO was initially used in adults; but later was also applied in the treatment of infants and children. In 1975, ECMO was first used to treat neonatal respiratory failure. Thus far, worldwide over 26,000 neonates with severe respiratory failure have been successfully treated with ECMO. An international registry reported an overall 75% survival rate at discharge4. There are two types of ECMO; venoarterial and venovenous. Venoarterial (VA) ECMO provides cardiac and pulmonary support to children with considerable circulatory instability and primary cardiac dysfunction. Primary respiratory failure is nowadays usually treated with venovenous (VV) ECMO, in all age groups. The survival rate for neonates treated with VA ECMO is estimated at 62%; that for neonates treated with VV ECMO at 85%.

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