Neonates treated with ECMO: predictive value of early CT and US neuroimaging findings on short-term neurodevelopmental outcome.

Abstract

To determine if neuroimaging findings in infants who undergo extracorporeal membrane oxygenation (ECMO) are predictive of developmental outcome. At 1-2 years of age, 183 ECMO survivors (69 female, 114 male) underwent developmental examination. Neuroimaging studies obtained at time of ECMO were assigned a neuroimaging score. Neuroimaging findings were correlated with developmental outcome. Eighty-five infants had neuroimaging abnormalities. Development was normal in 105 infants, suspect in 37, and delayed in 41. Mean neuroimaging scores were significantly worse in survivors with delayed development (P < or = .0001). The sensitivity and specificity of normal neuroimaging findings in prediction of normal outcome were 65% and 63%, respectively. Survivors with nonhemorrhagic abnormalities had a higher risk of delayed development than did those with isolated hemorrhagic abnormalities (39% vs 21%). Although they cannot be used alone to predict outcome, early neuroimaging scores can be used to assign risk categories for developmental outcome.