Marten J. Poley - Erasmus Universiteit Rotterdam

Cost-Effectiveness of Neonatal Extracorporeal Membrane Oxygenation in the Netherlands 81ECMO. 77,78 Second, follow-up studies frequently concentrate on levels ofsymptomatology and functioning, thereby failing to establish HRQoL. 79 Third,although there may be no clear evidence that the introduction of ECMO hascreated an increase in the percent of children surviving with poor long-termoutcomes, studies that compared to healthy children or did not include a controlgroup arrived—not surprisingly—at less favorable conclusions. 5,78,80,81 So,following these children into childhood and beyond still remains essential. It istherefore that we contact all Dutch ECMO patients at the ages of 5, 8, and 12years to undergo an assessment of neurologic and pulmonary sequelae, andmultidimensional HRQoL. The data at 5 years of age which we are currentlyanalyzing (recruitment rate of 88%) will provide us with representative data ofECMO patients in the Netherlands.5.5 CONCLUSIONSEspecially during its early application, considerable doubts have been expressedabout ECMO. The benefits of this therapy have always been consideredcontroversial to some extent, particularly regarding the patients with CDH. 82 Thisstudy however adds to the evidence that ECMO should not be withheld fromseverely ill newborns suffering from CDH or MAS for reasons purely of costeffectiveness.It remains for future studies to reveal whether the positiveoutcomes are maintained when long-term costs and HRQoL are included in theanalysis.ACKNOWLEDGMENTSThis study was supported by a grant from the Dutch Health Care Insurance Board (OG90-001).We are indebted to the staff of the neonatal intensive care units of Leiden University Hospital,Free University Hospital (Amsterdam), Academic Medical Center (Amsterdam), GroningenUniversity Hospital, Wilhelmina Children's Hospital (Utrecht), Maastricht University Hospital,and St Joseph Hospital (Veldhoven) who kindly gave us access to data on their patients. Wegratefully acknowledge previous work done by R.J.E. van Staveren, W.B. Geven, F.W.J.Hazebroek, C. Festen, and B.A. van Hout.