Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Intensive Care Medicine
Published in: Intensive Care Medicine 10/2013

01-10-2013 | Editorial

Looking beyond survival rates: neurological outcomes after extracorporeal life support

Authors: Kate L. Brown, Graeme MacLaren, Bradley S. Marino

Published in: Intensive Care Medicine | Issue 10/2013

Login to get access

Excerpt

Extracorporeal membrane oxygenation (ECMO) has been used since the 1970s to rescue the sickest of children with cardiopulmonary failure that are refractory to conventional intensive care therapies [1, 2]. As was shown in the UK randomized trial of ECMO for neonatal respiratory failure, patients requiring ECMO are at high risk of neurological injury [3]. In the current era, with improving survival rates for critically ill children and an expansion in the role of ECMO to include patients in cardiac arrest (ECPR, extracorporeal cardiopulmonary resuscitation) [4], there is growing awareness that it is inadequate to focus solely on short-term survival. Due to the neurologic morbidities associated with ECMO support, longer term outcomes including physical, neurodevelopmental, and psychosocial outcomes need to be monitored and carefully evaluated to optimize quality of life [5]. …
Literature
1.
Bartlett RH, Gazzaniga AB, Huxtable RF, Schippers HC, O’Connor MJ, Jefferies MR (1977) Extracorporeal circulation (ECMO) in neonatal respiratory failure. J Thorac Cardiovasc Surg 74(6):826–833 (Epub 1977/12/01)PubMed
2.
Bartlett RH, Gazzaniga AB, Toomasian J, Coran AG, Roloff D, Rucker R (1986) Extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure. 100 cases. Ann Surg 204(3):236–245 (Epub 1986/09/01)PubMedCrossRef
3.
UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation (1996) UK Collaborative ECMO Trail Group. Lancet 348(9020):75–82 (Epub 1996/07/13)CrossRef
4.
Thiagarajan RR, Laussen PC, Rycus PT, Bartlett RH, Bratton SL (2007) Extracorporeal membrane oxygenation to aid cardiopulmonary resuscitation in infants and children. Circulation 116(15):1693–1700 (Epub 2007/09/26)PubMedCrossRef
5.
Marino B, Uzark K, Ittenbach R, Drotar D (2010) Evaluation of quality of life in children with heart disease. Prog Pediatr Cardiol 29:131–138CrossRef
6.
Polito A, Barrett CS, Wypij D, Rycus P, Netto R, Cogo P et al (2013) Neurologic complications in neonates supported with extracorporeal membrane oxygenation. An analysis of ELSO registry data. Intensive Care Med. doi:10.​1007/​s00134-013-2985-x
7.
Madderom MJ, Reuser J, Utens EM, van Rosmalen J, Raets M, Govaert P et al (2013) Neurodevelopmental, educational and behavioural outcome at 8 years after neonatal ECMO: a nationwide multicenter study. Intensive Care Med. doi:10.​1007/​s00134-013-2973-1
8.
Marino BS, Drotar D, Cassedy A, Davis R, Tomlinson RS, Mellion K et al (2011) External validity of the pediatric cardiac quality of life inventory. Qual Life Res 20(2):205–214 (Epub 2010/12/29)PubMedCrossRef
9.
Wray J, Franklin R, Brown K, Cassedy A, Marino BS (2013) Testing the pediatric cardiac quality of life inventory in the United Kingdom. Acta Paediatr 102(2):e68–e73 (Epub 2012/11/27)
10.
ELSO (2013) Registry of the Extracorporeal Life Support Organisation. Ann Arbor, MI
11.
McNally H, Bennett CC, Elbourne D, Field DJ (2006) United Kingdom collaborative randomized trial of neonatal extracorporeal membrane oxygenation: follow-up to age 7 years. Pediatrics 117(5):e845–e854 (Epub 2006/04/26)PubMedCrossRef
12.
Bennett CC, Johnson A, Field DJ, Elbourne D (2001) UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation: follow-up to age 4 years. Lancet 357(9262):1094–1096 (Epub 2001/04/12)PubMedCrossRef
13.
Papademetriou MD, Tachtsidis I, Elliot MJ, Hoskote A, Elwell CE (2012) Multichannel near infrared spectroscopy indicates regional variations in cerebral autoregulation in infants supported on extracorporeal membrane oxygenation. J Biomed Opt 17(6):067008 (Epub 2012/06/28)PubMedCrossRef
14.
Azzopardi DV, Strohm B, Edwards AD, Dyet L, Halliday HL, Juszczak E et al (2009) Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med 361(14):1349–1358 (Epub 2009/10/03)PubMedCrossRef
15.
Field DJ, Firmin R, Azzopardi DV, Cowan F, Juszczak E, Brocklehurst P (2010) Neonatal ECMO study of temperature (NEST)–a randomised controlled trial. BMC Pediatr 10:24 (Epub 2010/04/21)PubMedCrossRef
16.
Hamrick SE, Gremmels DB, Keet CA, Leonard CH, Connell JK, Hawgood S et al (2003) Neurodevelopmental outcome of infants supported with extracorporeal membrane oxygenation after cardiac surgery. Pediatrics 111(6 Pt 1):e671–e675 (Epub 2003/06/05)PubMedCrossRef
17.
Glass P, Bulas DI, Wagner AE, Rajasingham SR, Civitello LA, Papero PH et al (1997) Severity of brain injury following neonatal extracorporeal membrane oxygenation and outcome at age 5 years. Dev Med Child Neurol 39(7):441–448 (Epub 1997/07/01)PubMedCrossRef
18.
Costello JM, O’Brien M, Wypij D, Shubert J, Salvin JW, Newburger JW, Laussen PC, Arnold JH, Fynn-Thompson F, Thiagarajan RR (2012) Quality of life of pediatric cardiac patients who previously required extracorporeal membrane oxygenation. Pediatr Crit Care Med 13(4):428–434PubMedCrossRef
19.
Lequier L, Joffe AR, Robertson CM, Dinu IA, Wongswadiwat Y, Anton NR et al (2008) Two-year survival, mental, and motor outcomes after cardiac extracorporeal life support at less than five years of age. J Thorac Cardiovasc Surg 136(4):976–983.e3 (Epub 2008/10/29)PubMedCrossRef
20.
Taylor A, Butt W, Ciardulli M (2003) The functional outcome and quality of life of children after admission to an intensive care unit. Intensive Care Med 29(5):795–800PubMed
21.
Iguchi A, Ridout DA, Galan S, Bodlani C, Squire K, O’Callaghan M et al (2013) Long-term survival outcomes and causes of late death in neonates, infants, and children treated with extracorporeal life support*. Pediatr Crit Care Med 14(6):580–586 (Epub 2013/07/05)PubMedCrossRef
22.
Marino BS, Lipkin PH, Newburger JW, Peacock G, Gerdes M, Gaynor JW et al (2012) Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 126(9):1143–1172 (Epub 2012/08/02)PubMedCrossRef
23.
MacLaren G, Dodge-Khatami A, Dalton H (2013) Pediatric Cardiac Intensive Care Society and Extracorporeal Life Support Organization joint statement on mechanical circulatory support in children: a consensus review. Pediatr Crit Care Med 14:S1–S2PubMedCrossRef
24.
Brown KL, Ichord R, Marino BS, Thiagarajan RR (2013) Outcomes following extracorporeal membrane oxygenation in children with heart disease. Pediatr Crit Care Med 14:S73–S83PubMedCrossRef
25.
Metadata
Title
Looking beyond survival rates: neurological outcomes after extracorporeal life support
Authors
Kate L. Brown
Graeme MacLaren
Bradley S. Marino
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 10/2013
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-013-3050-5

Other articles of this Issue 10/2013

Intensive Care Medicine 10/2013 Go to the issue

Seven-Day Profile Publication

Microparticles are new biomarkers of septic shock-induced disseminated intravascular coagulopathy

Seven-Day Profile Publication

The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome

Editorial

The new trials of early goal-directed resuscitation: three-part harmony or disharmony?

Original

An increased alveolar CD4 + CD25 + Foxp3 + T-regulatory cell ratio in acute respiratory distress syndrome is associated with increased 30-day mortality

Correspondence

Highlighting the important effect of systemic lupus erythematosus on platelet count of critically ill patients

Original

Early blood lactate area as a prognostic marker in pediatric septic shock