Maternal distress and perceptions of infant development following extracorporeal membrane oxygenation and conventional ventilation for persistent pulmonary hypertension

Neurodevelopmental outcome and concurrent maternal distress were examined for infants who suffered persistent pulmonary hypertension at birth and were treated with either extracorporeal membrane oxygenation (ECMO) ( n = 19) or conventional ventilation (CV) ( n = 15). Mothers were asked to complete inventories assessing their infant's (mean age 8.74 months) developmental growth as well as their own psychological health. Relevant sociodemographic and treatment parameters were also entered into the analysis. The results indicated that ECMO and CV infants did not differ on developmental indices and impairment rates were 15–23% respectively, similar to previous reports, in addition, ECMO and CV mothers did not differ in their reports of psychological distress. Correlational analyses revealed that length of treatment for ECMO but not CV infants significantly predicted developmental delay and maternal distress. For CV mothers, maternal distress was associated with the perception of delayed language. The results are discussed in terms of the limited morbidity associated with ECMO and CV interventions and the possible role of a ‘vulnerable child syndrome’ in understanding the maternal-infant relationship following ECMO therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73367/1/j.1365-2214.1995.tb00410.x.pd

Oxygen transport – The oxygen delivery controversy

Most cellular activities require energy in the form of oxygen, primarily obtained from the degradation of adenosine triphosphate (ATP) and other high-energy compounds. Oxygen must be present in sufficient amounts in the mitochondria to maintain effective concentrations of ATP in the electron transport system. Cells have to perform a series of activities essential for survival, including membrane transport, growth, cellular repair and maintenance processes. In addition, cells often have facultative functions such as contractility, electrolyte or protein transport, motility and various biosynthetic activities. If oxygen availability is limited, cellular oxygen consumption may fall and become supply-dependent. Facultative functions are the first to be altered, leading to organ dysfunction. If the situation becomes more serious, obligatory functions can no longer be maintained and irreversible alterations may occur. © 2006 Springer-Verlag Berlin Heidelberg.SCOPUS: ch.binfo:eu-repo/semantics/publishe