Congenital diaphragmatic hernia with(out) ECMO: impaired development at 8 years

Madderom, Marlous J.; Toussaint, Leontien; Zijp, Monique H M van der Cammen-van; Gischler, Saskia J.; Wijnen, René; Tibboel, Dick; IJsselstijn, Hanneke

doi:10.1136/archdischild-2012-303020

Cited by 62 publications

(84 citation statements)

References 31 publications

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“…31 Normal or even better perceived feelings of self-worth are not unusual; this has also been reported in children with congenital heart disease 32 and in CDH patients, whether or not treated with neonatal ECMO. 14 We showed that CDH patients were satisfied with their motor performance and had normal feelings of self-worth despite a higher proportion of actual motor function problems compared with the ECMO survivors without CDH.…”

Section: Discussionmentioning

confidence: 71%

“…On the basis of previous studies on motor impairments in neonatal ECMO survivors, 3,[6][7][8]10,14,18,19 we hypothesized that these children are likely to have low perceptions of competence in the physical domain because of repeated experiences of poor movement skills with loss of interest in the motor domain and avoidance of motor activities, due to fear of failure and peer criticism. It is conceivable that this may reduce opportunities to practice skills and participate socially and hence result in impaired HRQoL.…”

Section: Doimentioning

confidence: 99%

“…[11][12][13] To the best of our knowledge, the domains of selfworth, as well as perceived motor competence and social competence, have not yet been studied in ECMO survivors, except in those with CDH. 14 These domains may influence health-related quality of life (HRQoL). 15 Five-year-old and younger ECMO survivors had lower HRQoL scores on both physical and psychosocial domains.…”

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Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

et al. 2016

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OBJECTIVE: To assess perceived motor competence, social competence, self-worth, healthrelated quality of life, and actual motor performancein 8-year-old survivors of neonatal extracorporeal membrane oxygenation (ECMO). METHODS:In a prospective nationwide study, 135 children completed the extended version of the "athletic competence" domain of the Self Perception Profile for Children (SPPC) called the m-CBSK (Motor supplement of the Competentie BelevingsSchaal voor Kinderen) to assess perceived motor competence, the SPPC, and the Pediatric Quality of Life Inventory (PedsQL), andwere tested with the Movement Assessment Battery for Children. SD scores (SDS) were used to compare with the norm. RESULTS:The mean (SD) SDS for perceived motor competence, social competence, and selfworth were all significantly higher than the norm: 0.18 (0.94), P = .03; 0.35 (1.03), P < .001; and 0.32 (1.08), P < .001, respectively. The total PedsQL score was significantly below the norm: mean (SD) SDS: -1.26 (1.53), P < .001. Twenty-two percent of children had actual motor problems. The SDS m-CBSK and actual motor performance did not correlate (r = 0.12; P = .17). The SDS m-CBSK significantly correlated with the athletic competence domain of the SPPC (r = 0.63; P < .001).CONCLUSIONS: Eight-year-old ECMO survivors feel satisfied with their motor-and social competence, despite impaired PedsQL scores and motor problems. Because motor problems in ECMO survivorsdeteriorate throughout childhood, clinicians should be aware that these patients may tend to "overrate" their actual motor performance. Education andstrict monitoring of actual motor performanceare important to enable timelyintervention.a Department of Orthopedics, Section of Physical Therapy, and b Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands; c Department of Rehabilitation, Pediatric Physical Therapy and Donders Institute, Radboud University Medical Center, Nijmegen, Netherlands; and d Department of Neonatology, Radboud University Medical Center-Amalia Children's Hospital, Nijmegen, Netherlands Ms Toussaint contributed to the conception and design, acquisition of data, analysis and interpretation of data, and writing of the fi rst draft; Dr van der Cammen-van Zijp contributed to the conception and design, acquisition of data, analysis and interpretation of data, writing of the fi rst draft, and critically revising the manuscript; Dr Janssen contributed to the conception and design, acquisition of data, and critically revising the manuscript; Dr Tibboel contributed to the conception and design and critically revising the manuscript; Dr Heijst contributed to conception and design and to acquisition of data and critically revised the manuscript; Dr IJsselstijn contributed to the conception and design, acquisition of data, interpretation of data, writing of the fi rst draft, and critically revising the manuscript; and all authors approved the fi nal manuscript as submitted. Currently, t...

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Section: Discussionmentioning

confidence: 71%

Section: Doimentioning

confidence: 99%

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confidence: 99%

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Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

et al. 2016

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“…This confirms our earlier observations in 35 eightyear-old CDH survivors who had longterm problems with motor function and concentration, even when they had not been treated with ECMO. 21 A high presence of CLD and increased airflow obstruction that deteriorates over time 22 may contribute to poor motor function performance in these CDH patients.…”

Section: Discussionmentioning

confidence: 99%

Motor Performance After Neonatal Extracorporeal Membrane Oxygenation: A Longitudinal Evaluation

Zijp¹,

Janssen

Raets

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: After neonatal extracorporeal membrane oxygenation treatment, children are at risk for neurodevelopmental problems including delayed motor function. So far this has only been studied cross-sectionally until age 7 years. WHAT THIS STUDY ADDS:We describe, in a nationwide evaluation, the longitudinal course of motor function development after neonatal extracorporeal membrane oxygenation with persisting problems up to 12 years. At risk are children with congenital diaphragmatic hernia and those with chronic lung disease. abstract OBJECTIVE: To assess longitudinally children' s motor performance 5 to 12 years after neonatal extracorporeal membrane oxygenation (ECMO) and to evaluate associations between clinical characteristics and motor performance. METHODS:Two hundred fifty-four neonatal ECMO survivors in the Netherlands were tested with the Movement Assessment Battery for Children at 5, 8, and/or 12 years. Percentile scores were transformed to z scores for longitudinal evaluation (norm population mean = 0 and SD = 1). Primary diagnoses: meconium aspiration syndrome (n = 137), congenital diaphragmatic hernia (n = 49), persistent pulmonary hypertension of the newborn (n = 36), other diagnoses (n = 32). RESULTS:Four hundred fifty-six tests were analyzed. At 5, 8, and 12 years motor performance was normal in 73.7, 74.8, and 40.5%, respectively (vs 85% expected based on reference values; P , .001 at all ages). In longitudinal analyses mean (95% confidence interval [CI]) z scores were -0.42 (-0.55 to -0.28), -0.25 (-0.40 to -0.10) and -1.00 (-1.26 to -0.75) at 5, 8, and 12 years, respectively. Mean score at 8 years was significantly higher than at 5 years (difference 0.16, 95% CI 0.02 to 0.30), and mean score at 12 years was significantly lower than at both other ages (differences -0.59 and -0.75; 95% CI -0.33 to -0.84 and -0.49 to -1.00, respectively). Children with congenital diaphragmatic hernia encountered problems at all ages. The presence of chronic lung disease was negatively related with outcome.CONCLUSIONS: Motor problems in neonatal ECMO survivors persist throughout childhood and become more obvious with time. Pediatrics 2014;134:e427-e435 AUTHORS:

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“…15 Both tests assess verbal and nonverbal intelligence, have been shown to have good reliability and validity, 14,15 and have been used interchangeably by our group in previous research. 16 For all 4 tests, a normalized population mean ± SD IQ score of 100 ± 15 is used. 13 -15 The outcome on all 4 tests is referred to as intelligence or IQ.…”

Section: Intelligencementioning

confidence: 99%

Neuropsychological Follow-up After Neonatal ECMO

Schiller

Madderom

Reuser³

et al. 2016

Pediatrics

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OBJECTIVE: To assess the longitudinal development of intelligence and its relation to school performance in a nationwide cohort of neonatal extracorporeal membrane oxygenation (ECMO) survivors and evaluate predictors of outcome at 8 years of age. METHODS:Repeated measurements assessed intelligence of neonatal ECMO survivors at 2, 5, and 8 years (n = 178) with the use of validated, standardized instruments. Selective attention (n = 148) and type of education were evaluated in the 8-year-olds. RESULTS:Intelligence remained stable and average across development (mean ± SD IQ: at 2 years, 102 ± 18; at 5 years, 100 ± 17; and at 8 years, 99 ± 17 [P = .15]). Children attending regular education without the need for help (n = 101; mean z score: -1.50 ± 1.93) performed significantly better on the selective attention task compared with those children who needed extra help (n = 65; mean z score: -2.54 ± 3.18) or those attending special education (n = 13; mean z score: -4.14 ± 3.63) (P = .03). However, only children attending special education had below-average intelligence (mean IQ: 76 ± 15), compared with average intelligence for those attending regular education, both with help (mean IQ: 95 ± 15) and without help (mean IQ: 105 ± 16). Compared with children with other diagnoses, children with congenital diaphragmatic hernia (CDH) scored significantly lower on both IQ (CDH, mean IQ: 93 ± 20; meconium aspiration syndrome, mean IQ: 100 ± 15; other diagnoses, mean IQ: 100 ± 19 [P = .04]) and selective attention (CDH, mean z score: -3.48 ± 3.46; meconium aspiration syndrome, mean z score: -1.60 ± 2.13; other diagnoses, mean z score: -1.65 ± 2.39 [P = .002]). CONCLUSIONS:For the majority of neonatal ECMO survivors, intelligence testing alone did not identify those at risk for academic problems. We propose internationally standardized follow-up protocols that focus on long-term, problem-oriented neuropsychological assessment.

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Congenital diaphragmatic hernia with(out) ECMO: impaired development at 8 years

Abstract: Children with CDH-whether or not treated with neonatal ECMO-are at risk for long-term morbidity especially in the areas of motor function and concentration. Despite their impairment, children with CDH have a well-developed feeling of self-competence.

Cited by 62 publications

References 31 publications

Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

Motor Performance After Neonatal Extracorporeal Membrane Oxygenation: A Longitudinal Evaluation

Neuropsychological Follow-up After Neonatal ECMO

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