Quality of life and functional status of patients treated with venovenous extracorporeal membrane oxygenation at 6 months |
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| Institution: | 1. Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;2. Department of Statistics and Public Policy, Heinz College, Carnegie Mellon University, Pittsburgh, PA, United States of America;3. Department of Cardiothoracic Surgery, Heartlink ECMO Centre, Glenfield Hospital, Leicester, United Kingdom;4. Division of Pediatric Cardiothoracic Surgery, Department of Cardiothoracic and Vascular Surgery, Children''s Hospital at Montefiore, Bronx, New York, NY, United States of America;1. Graduation Program in Health Sciences, University of Brasília (UnB), Brasília, Federal District, Brazil;2. Nursing School, School of Health Sciences (ESCS), Brasília, Federal District, Brazil;3. Graduation Program in Nursing, University of Brasília (UnB), Brasília, Federal District, Brazil;4. Regulation Center of Federal District, Secretary of State of Health of the Federal District, Federal District, Brazil;5. Multiprofessional Residency Program in Primary Care, Oswaldo Cruz Foundation (FIOCRUZ), Federal District, Brazil;6. Law School, University Center of Brasilia (UniCEUB), Brasília, Federal District, Brazil;7. Graduation Program in Health Sciences, School of Health Sciences (ESCS), Brasília, Federal District, Brazil;8. Medical School, School of Health Sciences (ESCS), Brasília, Federal District, Brazil;1. Department of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, Université de Paris, 92110 Clichy, France;2. Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France;3. Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France;4. APHP, Département Epidémiologie Biostatistiques et Recherche Clinique, Hôpital Beaujon, 92110 Clichy, France;5. INSERM, CIC-EC 1425, Hôpital Bichat, 75018 Paris, France;1. Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-Calmettes, 232 boulevard de Sainte Marguerite, 13009 Marseille, France;2. Hematology Department, Institut Paoli-Calmettes, 232 boulevard de Sainte Marguerite, 13009 Marseille, France;1. Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada;2. Department of Medicine, University of Toronto, 6 Queen''s Park Crescent West, Third Floor, Toronto, ON, M5S 3H2, Canada;3. Division of Nephrology, Department of Medicine, St. Michael''s Hospital and University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada;4. Interdepartmental Division of Critical Care Medicine, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada;1. Bloomsbury Institute of Intensive Care Medicine, University College London, London WC1E 6BT, United Kingdom;2. Department of Clinical Virology, UCL Hospitals NHS Foundation Trust, London, United Kingdom;3. Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom;4. Division of Infection and Immunity, University College London, Gower St, London WC1E 6BT, United Kingdom;5. Department of Infection, Immunity and Inflammation, UCL, Great Ormond Street Institute of Child Health, London WC1N 1EH, United Kingdom;6. Advanced Pathogen Diagnostics Unit, Department of Clinical Virology, UCL Hospitals NHS Trust, London W1T 4EU, United Kingdom;7. Biology of Infection Laboratory, The Francis Crick Institute, London NW1 1AT, United Kingdom;8. Neuroimmunology and CSF Laboratory, UCL Hospitals NHS Foundation Trust, National Hospital of Neurology and Neurosurgery, Queen Square, London, United Kingdom;9. Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, United Kingdom;10. Retroviral Immunology Laboratory, The Francis Crick Institute, London NW1 1AT, United Kingdom;11. Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom;12. Department of Statistical Science, University College London, London, United Kingdom;13. NIHR University College London Hospitals (UCL) Biomedical Research Centre, United Kingdom |
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| Abstract: | PurposeQuality of life (QoL) outcomes of patients treated with extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) have been conflicting. This study reports on QoL outcomes for a broad group of ARDS patients managed with up-to-date treatment modalities.MethodsWe prospectively recruited patients at a quaternary hospital in the United Kingdom from 2013 to 2015 who were treated with ECMO for ARDS. We evaluated their pulmonary function and QoL at 6-months after admission using three QoL instruments: EuroQoL 5D (EQ-5), HADS, and PTSS-14.ResultsForty-three patients included in the analysis had near-normal pulmonary function at 6 months. HADS showed moderate-to-severe anxiety and depression in 32% and 11% of patients, respectively. PTSS-14 showed 29% had signs of post-traumatic stress disorder. EQ-5D showed that 67% of patients had difficulty returning to usual activities, 74% suffered some pain, none reported severe problems and 77% were able to return to work. No clinical or demographic variables were associated with poor 6-month QoL.ConclusionsPatients with ARDS treated with ECMO generally had good QoL outcomes, similar to outcomes reported for patients managed without ECMO. With respect to QoL, VV-EMCO represents a valid treatment modality for patients with refractory ARDS. |
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