Long-term follow-up of survivors of neonatal ECMO: what do we really know?

Extracorporeal membrane oxygenation (ECMO) has been used increasingly since the 1970s to treat serious respiratory diseases of infancy. However, much is unknown regarding developmental processes and outcomes in these high-risk children. Since the majority of children treated with ECMO have "normal" intelligence, they are often deemed developmentally appropriate by families and primary care providers in early childhood. Unfortunately, many children may exhibit cognitive deficits later, falling behind their peers in school during middle childhood. Predicted academic success cannot be based on IQ alone. Studies have shown that between 10% and 35% of ECMO survivors who are developing "normally" are in need of special educational services due to attention problems and/or express variability in functional abilities. Although the research data remain inconclusive, parents of children who undergo neonatal ECMO should be alerted to potential problems so that children can receive full assessments and appropriate interventions.