Looking beyond survival rates: neurological outcomes after extracorporeal life support

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]. …