Katharine Boyle1, Ryan Felling2, Alvin Yiu1, Wejdan Battarjee1, Jamie McElrath Schwartz1,3, Cynthia Salorio4, Melania M Bembea1,3. 1. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 2. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD. 3. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD. 4. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract
OBJECTIVES: The goal of this systematic review of the literature was to summarize neurologic outcomes following neonatal and pediatric extracorporeal membrane oxygenation. DATA SOURCES: We conducted electronic searches of PubMed, Scopus, Web of Science, CINAHL, Cochrane, and EMBASE. STUDY SELECTION: Inclusion criteria included publication dates 2000-2016, patient ages 0-18 years, and use of standardized measures to evaluate outcomes after extracorporeal membrane oxygenation. DATA EXTRACTION: We identified 3,497 unique citations; 60 full-text articles were included in the final review. DATA SYNTHESIS: Studies evaluated patients with congenital diaphragmatic hernia (7), cardiac disease (8), cardiac arrest (13), and mixed populations (32). Follow-up was conducted at hospital discharge in 10 studies (17%) and at a median of 26 months (interquartile range, 8-61 mo) after extracorporeal membrane oxygenation in 50 studies (83%). We found 55 outcome measures that assessed overall health and function (4), global cognitive ability (7), development (4), motor function (5), adaptive function (2), behavior/mood (6), hearing (2), quality of life (2), school achievement (5), speech and language (6), learning and memory (4), and attention and executive function (8). Overall, 10% to as many as 50% of children scored more than 2 SDS below the population mean on cognitive testing. Behavior problems were identified in 16-46% of children tested, and severe motor impairment was reported in 12% of children. Quality of life of former extracorporeal membrane oxygenation patients evaluated at school age or adolescence ranged from similar to healthy peers, to 31-53% having scores more than 1 SD below the population mean. CONCLUSIONS: This systematic review of the literature suggests that children who have undergone extracorporeal membrane oxygenation suffer from a wide range of disabilities. A meta-analysis was not feasible due to heterogeneity in pathologies, outcome measures, and age at follow-up, underscoring the importance of developing and employing a core set of outcomes measures in future extracorporeal membrane oxygenation studies.
OBJECTIVES: The goal of this systematic review of the literature was to summarize neurologic outcomes following neonatal and pediatric extracorporeal membrane oxygenation. DATA SOURCES: We conducted electronic searches of PubMed, Scopus, Web of Science, CINAHL, Cochrane, and EMBASE. STUDY SELECTION: Inclusion criteria included publication dates 2000-2016, patient ages 0-18 years, and use of standardized measures to evaluate outcomes after extracorporeal membrane oxygenation. DATA EXTRACTION: We identified 3,497 unique citations; 60 full-text articles were included in the final review. DATA SYNTHESIS: Studies evaluated patients with congenital diaphragmatic hernia (7), cardiac disease (8), cardiac arrest (13), and mixed populations (32). Follow-up was conducted at hospital discharge in 10 studies (17%) and at a median of 26 months (interquartile range, 8-61 mo) after extracorporeal membrane oxygenation in 50 studies (83%). We found 55 outcome measures that assessed overall health and function (4), global cognitive ability (7), development (4), motor function (5), adaptive function (2), behavior/mood (6), hearing (2), quality of life (2), school achievement (5), speech and language (6), learning and memory (4), and attention and executive function (8). Overall, 10% to as many as 50% of children scored more than 2 SDS below the population mean on cognitive testing. Behavior problems were identified in 16-46% of children tested, and severe motor impairment was reported in 12% of children. Quality of life of former extracorporeal membrane oxygenation patients evaluated at school age or adolescence ranged from similar to healthy peers, to 31-53% having scores more than 1 SD below the population mean. CONCLUSIONS: This systematic review of the literature suggests that children who have undergone extracorporeal membrane oxygenation suffer from a wide range of disabilities. A meta-analysis was not feasible due to heterogeneity in pathologies, outcome measures, and age at follow-up, underscoring the importance of developing and employing a core set of outcomes measures in future extracorporeal membrane oxygenation studies.
Authors: Adrian C Mattke; Christian F Stocker; Andreas Schibler; Nelson Alphonso; Kerry Johnson; Tom R Karl Journal: Intensive Care Med Date: 2015-09-10 Impact factor: 17.440
Authors: R Van Litsenburg; N De Mos; D Edgell; C Gruenwald; D J Bohn; C S Parshuram Journal: Arch Dis Child Fetal Neonatal Ed Date: 2005-03 Impact factor: 5.747
Authors: Gonzalo Garcia Guerra; Charlene M T Robertson; Gwen Y Alton; Ari R Joffe; Elham Khodayari Moez; Irina A Dinu; David B Ross; Ivan M Rebeyka; Laurance Lequier Journal: Pediatr Crit Care Med Date: 2014-10 Impact factor: 3.624
Authors: Melania M Bembea; William Savage; John J Strouse; Jamie McElrath Schwartz; Ernest Graham; Carol B Thompson; Allen Everett Journal: Pediatr Crit Care Med Date: 2011-09 Impact factor: 3.624
Authors: Marlous J Madderom; Leontien Toussaint; Monique H M van der Cammen-van Zijp; Saskia J Gischler; René M H Wijnen; Dick Tibboel; Hanneke Ijsselstijn Journal: Arch Dis Child Fetal Neonatal Ed Date: 2012-12-12 Impact factor: 5.747
Authors: Marlous J Madderom; Jolanda J C M Reuser; Elisabeth M W J Utens; Joost van Rosmalen; Marlou Raets; Paul Govaert; Katerina Steiner; Saskia J Gischler; Dick Tibboel; Arno F J van Heijst; Hanneke Ijsselstijn Journal: Intensive Care Med Date: 2013-06-06 Impact factor: 17.440
Authors: Heather K Chandler; Beatriz Teppa; Khaliah A Johnson; Courtney McCracken; James D Fortenberry; Matthew L Paden Journal: J Crit Care Date: 2015-06-24 Impact factor: 3.425
Authors: Irfaan A Dar; Imad R Khan; Ross K Maddox; Olga Selioutski; Kelly L Donohue; Mark A Marinescu; Sunil M Prasad; Nadim H Quazi; Jack S Donlon; Emily A Loose; Gabriel A Ramirez; Jingxuan Ren; Joseph B Majeski; Kenneth Abramson; Turgut Durduran; David R Busch; Regine Choe Journal: Biomed Opt Express Date: 2020-10-19 Impact factor: 3.732
Authors: Valentina Di Leo; Paolo Biban; Federico Mercolini; Francesco Martinolli; Andrea Pettenazzo; G Perilongo; Angela Amigoni Journal: Childs Nerv Syst Date: 2018-11-10 Impact factor: 1.475
Authors: Augusto Zani; Wendy K Chung; Jan Deprest; Matthew T Harting; Tim Jancelewicz; Shaun M Kunisaki; Neil Patel; Lina Antounians; Pramod S Puligandla; Richard Keijzer Journal: Nat Rev Dis Primers Date: 2022-06-01 Impact factor: 52.329
Authors: Melania M Bembea; Derek K Ng; Megan Carroll; Jennifer L Roem; John Groopman; Sherrill D Caprarola; Jamie McElrath Schwartz; Ryan J Felling; Cynthia F Salorio; Greg Ellis; David Graham; Allen D Everett Journal: ASAIO J Date: 2022-03-01 Impact factor: 3.826
Authors: Sarah L Bauer Huang; Ahmed S Said; Christopher D Smyser; John C Lin; Kristin P Guilliams; Réjean M Guerriero Journal: J Child Neurol Date: 2020-10-28 Impact factor: 1.987
Authors: Daniël Bossen; Rosa M de Boer; Hendrika Knoester; Jolanda M Maaskant; Marike van der Schaaf; Mattijs W Alsem; Reinoud J B J Gemke; Job B M van Woensel; Jaap Oosterlaan; Raoul H H Engelbert Journal: Crit Care Explor Date: 2021-06-15