NEUROBEHAVIORAL OUTCOME OF ECMO NEONATES AT AGE 5

体外膜氧合(Ecmo)是一种激进的治疗方法。 到患有严重心肺衰竭的危重新生儿。 幸存者代表了一个独特的儿童群体，他们可能会死亡 在程序出台之前，谁有很高的可能性 有持续的新生儿脑损伤。考虑到疾病的严重性 在ECMO插管治疗前的ECMO候选患者中， 程序中固有的风险，证据证明了显著的 发育中的大脑适应这种侮辱的潜力。然而，只有 关于幸存者的研究有限，而使用 程序正在迅速扩大。短期的随访就足够了 仅限重大障碍。其中一项发表的长期研究只包含16项 孩子们。我们建议对150名5岁儿童进行随访，从 我们目前的队列是在新生儿时接受ECMO治疗的。所有人都有例行公事 新生儿期的神经成像。性能将被比作控件 正常、健康的5岁儿童50例。性别、种族和母亲 教育程度将受到控制。一个综合性的多学科 将采用标准、基础广泛的评估方法 评估主要障碍的技术，更有针对性和详细 评估以记录听觉/语言或语言方面的表现 视觉/知觉技能、感觉-运动完整性、注意力和 行为问题和神经运动功能障碍。这件事的意义 研究表明，它将评估神经行为的长期发病率 在一大群ECMO幸存者中，他们即将达到上学年龄。这个 这些发现也将有助于理解大脑的后果 近足月新生儿的损害。

Extracorporeal membrane oxygenation (ECMO) is a drastic treatment applied to critically ill near term neonates in severe cardiorespiratory failure. The survivors represent a unique population of children who would have died prior to the introduction of the procedure, and who have a high probability of having sustained neonatal brain trauma. Given the severity of illness among ECMO candidates prior to treatment with ECMO cannulation, and the risks inherent in the procedure, the evidence attests to the remarkable potential of the developing brain to adapt to such insult. However, only limited research is available regarding the survivors, and the use of the procedure is rapidly expanding. Short term follow-up is sufficient for major handicap only. The one published longterm study contained only 16 children. We propose a follow-up of 150 children at 5 years of age from our current cohort who were treated with ECMO as neonates. All had routine neuroimaging in the newborn period. Performance will compared to a control group of 50 normal, healthy 5-year old children. Sex, race, and maternal level of education will be controlled. A comprehensive multidisciplinary approach to assessment will be employed, with both standard, broad-based techniques to evaluate major handicap, and more focused and detailed assessments to document performance in areas of auditory/linguistic or visual/perceptual skills, sensory-motor integrity, attentional and behavioral problems, and neuromotor dysfunction. The significance of this research is that it will evaluate the longterm neurobehavioral morbidity among a large cohort of ECMO survivors as they approach school age. The findings will also contribute to understanding the consequences of brain lesions in near term neonates.