Developmental Evaluation of Infants Treated with ECMO during Their Newborn Period: Preliminary Results of a Single Center

Year 2019, Volume: 13 Issue: 1, 19 - 24, 21.03.2019

E. Bahar Bingöller Pekcici

https://doi.org/10.12956/tjpd.2018.354

Abstract

 Objective: The infants who received extracorporeal membrane oxygenation (ECMO) support in the neonatal period may have life-long developmental risks. The objective of this study was to determine the developmental risk factors and developmental status at the 1st and 2nd year follow-up evaluations of the infants who were supported with ECMO in the neonatal period at Ankara University (AU) Neonatal Intensive Care Unit (NICU). 

Material and Methods: Infants in this research were evaluated with the information of perinatal risk factors, neonatal intensive care unit progress and the evaluations with the Expanded-Guide for Monitoring Child Development (Exp- GMCD), Guide for Monitoring Child Development (GMCD), and the Bayley Scales of Infant Development-III (BSID-III). 

Results: The sample consisted of 8 babies who survived from 12 newborns who received ECMO support at AU NICU between September 2015 and September 2017. One of the babies with Down syndrome had significant developmental delays in the language, cognitive, fine and gross motor domains at 1st and 2nd year follow-up and another baby had an expressive language delay at the 2nd year evaluation. 

Conclusion: According to the developmental assessment of the infants who received ECMO support at the AU NICU, 75% (6 cases) were developed age-appropriately in all developmental domains with standardized tools. It is important to monitor the development of these children with a transdiciplinary approach to determine risk factors, support early childhood development and the family, and provide early diagnosis and intervention. 

Keywords

ECMO, Development, Developmental difficulty

Yenidoğan Döneminde Ekstrakorporeal Membran Oksijenasyonu (ECMO) Uygulanan Bebeklerin Gelişimsel Değerlendirilmesi: Tek Merkezden İlk Sonuçlar

Abstract

 Amaç: Yenidoğan döneminde Ekstrakorporeal Membran Oksijenasyonu (ECMO) desteği alan bebekler yaşam boyu gelişimsel sorunlar için risk taşımaktadır. Araştırmanın amacı Ankara Üniversitesi (AÜ) Yenidoğan Yoğun Bakım Ünitesinde ECMO desteği almış olan yenidoğanların gelişimsel risklerinin, 1 ve 2 yaş izlemlerindeki gelişimsel durumlarının belirlenmesidir. 

Gereç ve Yöntemler: Bu araştırmadaki bebekler, perinatal risk etmenleri ve yenidoğan yoğun bakım izlemi bilgileri, G-GİDR (Genişletilmiş Gelişimi İzleme ve Destekleme Rehberi), GİDR (Gelişimi İzleme ve Destekleme Rehberi) ve BSID-III (Bayley Bebeklik ve Erken Çocukluk Dönemi Gelişimi Değerlendirme Ölçeği) araçları kullanılarak değerlendirilmiştir. 

Bulgular: Ankara Üniversitesi Tıp Fakültesi Yenidoğan Yoğun Bakım Ünitesinde Eylül 2015-Eylül 2017 tarihleri arasında ECMO desteği alan 12 bebekten yaşamda kalan 8’i örneklemi oluşturmaktadır. Bir bebek Down sendromu tanılı olup, 1 ve 2 yaş izleminde, dil, bilişsel, ince ve kaba hareket gelişim alanlarında belirgin gelişimsel gecikmesi bulunmuştur, bir bebekte ise 2 yaş değerlendirmesinde ifade dili gelişiminde gecikme saptanmıştır. 

Sonuç: Ankara Üniversitesi Yenidoğan Yoğun Bakım Ünitesinde ECMO desteği almış bebeklerin dil, bilişsel ve hareket gelişimleri standart araçlarla değerlendirildiğinde %75’inin (6 olgu) gelişimi tüm alanlarda yaşıyla uyumlu bulunmuştur. Bu bebeklerin gelişimsel risklerinin saptanması, gelişimin ve ailenin desteklenmesi, erken tanı ve girişimlerin sağlanması amacıyla transdisipliner yaklaşım ile gelişimsel izlemleri önem taşımaktadır. 

Keywords

ECMO, Gelişim, Gelişimsel zorluk

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