Psychological outcome of ECMO-eligible neonates with severe respiratory failure treated using conventional medical therapy.

OBJECTIVE

The present study addressed a National Health and Medical Research Council (NHMRC) recommendation that the outcome of neonates who are treated conventionally for respiratory problems be further investigated before setting up additional extracorporeal membrane oxygenation (ECMO) centres in Australia.

METHODOLOGY

The cognitive and behavioural outcome of ECMO eligible infants who received conventional treatment for respiratory problems at birth was assessed in 18 infants aged 1.5-3 years (index group). ECMO was not available at either of the treating hospitals. Index children were compared to a matched control group of children who did not experience any major complications at birth. Children were assessed using either the Bayley or McCarthy scales of infant development and the Child Behavior Checklist.

RESULTS

Overall, a mortality rate of 19% and a psychological morbidity rate of 18% suggest that children born with severe respiratory failure, who meet existing ECMO eligibility criteria, have a good prognosis when treated using conventional medical therapy.

CONCLUSIONS

Improvements to conventional treatments indicate that ECMO eligibility criteria may need to be revised to identify accurately those infants who are at extreme risk of mortality if treated conventionally.