NEURO-OUTCOME OF ECMO SURVIVORS--FACTS AND PREDICTORS

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This study seeks to understand the neurologic outcome of survivors of extracorporeal membrane oxygenation (ECMO). The training aspect will improve the PI's expertise in the following areas: clinical study design, data collection, biostatistical evaluation, managing a multidisciplinary study, and video EEG/neurophysiology skills. The PI's goals are to become a well-rounded clinical neonatal neurophysiologist. Specific clinical study aims include: 1. Determination of the incidence of poor neurologic outcome in ECMO survivors. 2. Identification of risk factors for poor neurologic outcome in ECMO survivors. 3. Determination of the incidence of epilepsy in ECMO survivors. 4. Identification of risk factors for epilepsy in ECMO survivors, especially the validity of EEG-documented neonatal seizures. A cohort of all ECMO survivors will be utilized in a long-term, multidisciplinary clinical study of neurologic outcome as measured by neurophysiologic studies (EEG), neurologic exams, and neuropsychological tests. This cohort will be evaluated to determine if certain events (such as stroke) establish high risk for poor* neurologic outcome. Additionally, other potential risk factors (such as gestational age, pulmonary diagnosis, etc) will be examined with univariate and multivariate analyses, ana and logistic regression analyses. In a similar fashion, the incidence of epilepsy in survivors will be determined and risk factors identified. Particular attention will be paid to the significance of EEG-documented seizures as a predictor for later epilepsy. ECMO therapy is available at 82 centers in the U.S.A. This study will provide a comprehensive outcome of ECMO survivors for prognostic purposes. The information generated in this study may have significant value in cost/risk/benefit analyses required to evaluate such aggressive therapy.