OUTCOME OF ECMO VS NEAR MISS ECMO PATIENTS AT FIVE YEARS OF AGE:† 1640

A total of one hundred and sixteen ECMO patients have been evaluated in our center at five years of age. Excluding the patients with primary diagnosis of congenital diaphragmatic hernia and sepsis, allowed us to compare 76 of five-year-old ECMO patients with 20, five-year-old Near Miss ECMO patients with similar primary diagnosis. Both groups were similar in gestational age, sex, Apgar scores and their primary diagnosis of pulmonary disease. Mean birth weight of ECMO patients (3.40 ± 0.60 Kg) was significantly higher than Near Miss group (3.02 ± 0.68 Kg) (p<.02). ECMO patients required higher maximum PIP (49 ± 11) vs (39 ± 7) for Near Miss patients. Although hours on PIP>40 was similar in both groups (22 ± 26 vs 26± 42), the Near Miss group spent longer time on PIP over 30 (75± 81 vs 42 ± 31), FiO₂>0.70 (121 ± 81 vs 51± 34) and FiO₂ of 1.00 (55 ± 71 vs 38 ± 23), and had longer duration of PCO₂<30 (93 ± 64 vs 32 ± 35) respectively. Both groups had similar ethnic distribution and socioeconomic status as it was assessed by number of patients living in a single parent family, level of maternal education and home screening questionnaire. All 76 ECMO patients and 10 of the 20 Near Miss patients had neuroimaging studies. Total of 9 ECMO patients and 2 of the Near Miss patients that were studied had major neuroimaging abnormalities. Mean Full Scale IQ in ECMO patients was 96.88 ± 20.09 vs 91.50 ± 22.34 in Near Miss ECMO (p=.32). Academic screening for reading, writing, and arithmetic was similar in both groups with 46% of ECMO and 56% of Near Miss patients being at risk for school failure (p=.47). Parental reporting of psychosocial problems was similar for behavior adjustment and level of maternal stress, although parents of Near Miss patients reported an increased rate of child immaturity compared to ECMO patients (p=.005).

Although both ECMO and Near Miss ECMO patients have similar outcome at five years of age, a significant number of both groups are at risk for school performance failure, therefore close and long-term follow-up of ECMO and Near Miss ECMO patients is essential.