Congenital diaphragmatic hernia with(out) ECMO: impaired development at 8 years.

Autor: Madderom MJ; Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Dr. Molewaterplein 60; Rotterdam, The Netherlands., Toussaint L, van der Cammen-van Zijp MH, Gischler SJ, Wijnen RM, Tibboel D, Ijsselstijn H
Jazyk: angličtina
Zdroj: Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2013 Jul; Vol. 98 (4), pp. F316-22. Date of Electronic Publication: 2012 Dec 12.
DOI: 10.1136/archdischild-2012-303020
Abstrakt: Objective: To evaluate developmental and social-emotional outcomes at 8 years of age for children with congenital diaphragmatic hernia (CDH), treated with or without neonatal extracorporeal membrane oxygenation (ECMO) between January 1999 and December 2003.
Design: Cohort study with structural prospective follow-up.
Setting: Level III University Hospital.
Patients: 35 children (ECMO: n=16; non-ECMO: n=19) were assessed at 8 years of age.
Interventions: None.
Main Outcome Measures: Intelligence and motor function. Concentration, behaviour, school performance, competence and health status were also analysed.
Results: Mean (SD) intelligence for the ECMO group was 91.7 (19.5) versus 111.6 (20.9) for the non-ECMO group (p=0.015). Motor problems were apparent in 16% of all participants and differed significantly from the norm (p=0.015) without differences between treatment groups. For all participants, problems with concentration (68%, p<0.001) and with behavioural attention (33%, p=0.021) occurred more frequently than in reference groups, with no difference between treatment groups. School performance and competence were not affected.
Conclusions: Children with CDH-whether or not treated with neonatal ECMO-are at risk for long-term morbidity especially in the areas of motor function and concentration. Despite their impairment, children with CDH have a well-developed feeling of self-competence.
Databáze: MEDLINE
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