Introduction: To detect any complications which may develop because of ECMO, the following tests have been recommended as a post-ECMO protocol: Basal auditory evoked response (BAER), head CT, cerebral blood flow(CBF), CMV culture, head ultrasound (HUS), EEG, eye exam for retinopathy of prematurity, and pneumocardiogram (PCG). However, it is uncertain whether these guidelines conform to current practice. The purpose of this study was to survey all post-ECMO tests as to their cost and evaluate each test to detect any change in the incidence of unexpected medical problems.

Methods: A review of all surviving neonatal ECMO patients at Kosair Children's Hospital between 1985-94 (n=296) was conducted for post-ECMO tests and their results.

Results: The characteristics of the patient sample are summarized below: Table

Table 1
Full size table

Conclusions: These results suggest the exclusion of CBF, eye exams, and pneumocardiograms from the current post-ECMO protocol with certain exceptions. We would recommend to continue obtaining BAER (p<.01, cost$418)), head CT (p<.01, cost $604), and EEG (p<.01, cost $300) as these were all significantly increased over expected. This study implies that in addition to saving most patients from unnecessary tests, over $1200 can be saved by excluding these three tests.