儿科体外膜肺氧合存活患儿中心插管的神经发育结局。

Neurodevelopmental Outcomes of Pediatric Cardiac Extracorporeal Membrane Oxygenation Survivors With Central Cannulation.

机构信息

Ozlem Saritas Nakip, Selman Kesici, Gokcen Duzgun Konuskan, Hacettepe University Faculty of Medicine, Ankara, 06560, Türkiye; Mutlu Uysal Yazici, Gazi University, Faculty of Medicine, Ankara, 06500, Türkiye; Bahadır Konuskan, Ankara Etlik Integrated Health Campus, Ankara, 06170, Türkiye; and Benan Bayrakci, Hacettepe University Faculty of Medicine, Ankara, 06560, Türkiye.

出版信息

Am J Intellect Dev Disabil. 2024 Sep 1;129(5):377-386. doi: 10.1352/1944-7558-129.5.377.

DOI:10.1352/1944-7558-129.5.377

PMID:39197851

Abstract

Extracorporeal life support, such as pediatric cardiac extracorporeal membrane oxygenation (ECMO), is associated with significant mortality and morbidity risk. This study evaluated cardiac ECMO survivors with central cannulation and found that 51.1% were discharged from the hospital. The study also revealed high rates of developmental delay (82.7%), motor dysfunction (58.8%), and cognitive dysfunction (70.6%) among survivors. No significant correlation was found between the duration of ECMO, age at ECMO, pre-ECMO maximum lactate levels, and cognitive scores. Participants with motor dysfunction were significantly younger (p = 0.04). PRISM scores of those with an abnormal developmental status were significantly higher (p = 0.03). Logistic regression analysis did not show a significantly increased risk. Factors such as age, disease severity, and ECMO itself were identified as potential contributors to neurodevelopmental delay.

摘要

体外生命支持，如儿科心脏体外膜氧合（ECMO），与显著的死亡率和发病率风险相关。本研究评估了接受中心插管的心脏 ECMO 幸存者，发现 51.1%的患者从医院出院。研究还显示，幸存者中发育迟缓（82.7%）、运动功能障碍（58.8%）和认知功能障碍（70.6%）的发生率较高。ECMO 持续时间、ECMO 时的年龄、ECMO 前最大乳酸水平与认知评分之间没有显著相关性。运动功能障碍患者明显更年轻（p=0.04）。发育异常患者的 PRISM 评分明显更高（p=0.03）。逻辑回归分析未显示风险显著增加。年龄、疾病严重程度和 ECMO 本身等因素被认为是导致神经发育迟缓的潜在因素。