Sensorineural Hearing Loss and Language Development Following Neonatal Extracorporeal Membrane Oxygenation

Abstract

OBJECTIVE:To determine the prevalence of hearing loss in school-age children who have undergone neonatal extracorporeal membrane oxygenation (ECMO) treatment and to identify any effects of hearing loss on speech-and language development. DESIGN:Prospective longitudinal follow-up study within the framework of a structured post-ECMO follow-up program.SETTING: Outpatient clinic of a level III university hospital. RESULTS:Tone audiometry was performed by standardized protocol in 136 children aged 5 to 12 years. Hearing loss was considered clinically significant when >20dB. Hearing was normal in 75.7% of children. Five children (3.7%) had bilateral sensorineural or combined hearing loss; 3 of them received special audiological care (2.2% of total sample). Of the 24 children with congenital diaphragmatic hernia, 19 (79.2%) had normal hearing; and only 2 (8.3%) had mild SNHL, unilateral in one of them.Follow-up at 24 months of age had shown normal verbal and non-verbal developmental scores.Language development and intelligence median (range) scores at 5 years of age were also normal: receptive language development 104 (55-133); syntactical development 104 (68-132); and lexical development 101 (50-141) for 89 children; intelligence quotient was 104 (68-132) in 106 children.Scores did not differ between those with normal hearing, and those with mild hearing loss, or those with moderate to severe hearing loss (p=0. 800, p=0.639, p=0.876, and p=0.886, for the respective developmental tests). CONCLUSIONS:We found normal language development and intelligence in a cohort of neonatal ECMO survivors. The prevalence of bilateral sensorineural hearing loss was in accordance with that of larger series in the United States -which exceeds the prevalence in the normal population.3

Neuropsychological Follow-up After Neonatal ECMO

“…Using the current guidelines, neonatal ECMO survivors at risk for school problems will not be identified. 6,7,[25][26][27] We therefore propose a problemoriented revision of follow-up protocols. persist even into adolescence, 2 -4 neuropsychological follow-up that extends beyond the age of 5 years is crucial.…”

Neurologic Outcomes After Extracorporeal Membrane Oxygenation: A Systematic Review

“…Most studies concluded that global ability of former ECMO patients was not severely affected, with mean scores for the ECMO patients falling within 1 SD of the population mean (5, 6, 11, 15, 17, 19, 24, 26, 27, 29, 34–36, 55, 58). Four studies demonstrated mean scores for cognitive ability <80 (population mean, 100, SD, 15) (13, 16, 49, 51).…”

Extracorporeal membrane oxygenation support in a newborn with lower urinary tract obstruction and pulmonary hypoplasia: a case report

“…The neurological long-term outcome of children with congenital renal failure has not yet been studied prospectively, but it seems to be appropriate for age in most patients [ 2 ]. In a prospective follow-up study by van den Hondel et al [ 17 ], 24.3% of the ECMO survivors had hearing loss, but they showed normal intelligence scores and language skills at the age of 5 years. Several long-term outcome studies on children with congenital renal failure have been done with a focus on renal outcome and general survival, not taking into account the possibility of ECMO support.…”