INTRODUCTION: Differentiation of neurodevelopmental outcome across primary diagnostic categories has recently been reported in a sample of ECLS survivors at age 1 year (PEDIATRICS 1995;96:913). Specifically, infants with congenital diaphragmatic hernia (CDH) had lower motor (MDI) and cognitive (PDI) scores on the Bayley Scales of Infant Development(BSID) compared to infants with other diagnoses (MAS, RDS, etc). The purpose of this investigation was to compare diagnostic categories longitudinally for developmental outcome in ECLS survivors as they reached school age.METHODS: 71 of 77 surviving neonates were treated with ECLS at our institution from 1985-1990 and were followed since discharge. All were ≥ 5 yrs and were evaluated with the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R). The remaining 6/77 (8%) surviving children had severe intellectual and/or motor deficits and were untestable. We present scores from the BSID-II (12 mo) and the WPPSI-R (5 yrs). RESULTS:Table At school age the following were noted in 34/71(48%) children: mental retardation (5), cerebral palsy (4), hearing loss (6), and learning disability (19). These conditions tended to occur more commonly in children who had a primary diagnosis of RDS (10/15 with RDS).

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CONCLUSIONS: Primary diagnoses (particularly CDH) in ECLS survivors were not predictive of later developmental outcome. We recommend longitudinal neurodevelopmental assessment of ECLS survivors across diagnostic categories.