Waitzer Elana, Riley S P, Perreault Therese, Shevell Michael I
Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
J Child Neurol. 2009 Jul;24(7):801-6. doi: 10.1177/0883073808330765. Epub 2009 Feb 5.
The neurologic outcomes at school age in children who underwent neonatal extracorporeal membrane oxygenation for noncardiac indications in a single institution surviving till the age of 5 years was determined by standardized neurologic assessment. Of 42 newborns undergoing extracorporeal membrane oxygenation, 24 underwent neurologic assessment by a single neurologist at 5 years of age. In all, 12 (50%) had a normal neurologic outcome. Lower gestational age and birth weight was found to be associated with an abnormal outcome as was septic shock as an indication for extracorporeal membrane oxygenation initiation. The number of peri-extracorporeal membrane oxygenation complications experienced by a child was associated with later epilepsy. Although invasive and implemented in critically ill infants, half of newborns undergoing extracorporeal membrane oxygenation will have a normal neurologic outcome at school age. Preexisting factors, rather than factors related to the extracorporeal membrane oxygenation itself, appear to be greater determinants of later neurologic outcomes.
在一家机构中，对因非心脏适应症接受新生儿体外膜肺氧合且存活至5岁的儿童，在学龄期的神经学转归通过标准化神经学评估来确定。在42名接受体外膜肺氧合的新生儿中，24名在5岁时由一名神经科医生进行了神经学评估。总体而言，12名（50%）神经学转归正常。发现较低的胎龄和出生体重与异常转归相关，作为启动体外膜肺氧合指征的感染性休克也是如此。儿童经历的体外膜肺氧合围手术期并发症数量与后期癫痫有关。尽管体外膜肺氧合具有侵入性且用于危重症婴儿，但接受体外膜肺氧合的新生儿中有一半在学龄期将有正常的神经学转归。先前存在的因素，而非与体外膜肺氧合本身相关的因素，似乎是后期神经学转归的更大决定因素。
