Filippo Sanfilippo1, Mariachiara Ippolito2, Cristina Santonocito3, Gennaro Martucci3, Tiziana Carollo3, Alessandro Bertani4, Patrizio Vitulo4, Michele Pilato4, Giovanna Panarello3, Antonino Giarratano2, Antonio Arcadipane3. 1. Department of Anesthesia and Intensive Care, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy - filipposanfi@yahoo.it. 2. Section of Anesthesia Analgesia Intensive Care and Emergency, Department of Biopathology and Medical Biotechnologies (DIBIMED), P. Giaccone Polyclinic, University of Palermo, Palermo, Italy. 3. Department of Anesthesia and Intensive Care, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy. 4. Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy.
Abstract
BACKGROUND: Acute respiratory distress syndrome (ARDS) survivors are affected with long-term physical/mental impairments, with improvements limited mostly to the first year after intensive care (ICU) discharge. Furthermore, caregivers of ICU patients exhibit psychological problems after family-member recovery. We evaluated the long-term physical and mental recovery of ARDS survivors treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO), and the long-term psychological impact on their caregivers. METHODS: Single-center prospective evaluation of a retrospective cohort of 75 ARDS patients treated with VV-ECMO during a seven-year period (25.10.2009-11.08.2016). Primary outcomes were the 36-Item Short-Form Health-Survey (SF-36, patients only), and risks of depression, anxiety or post-traumatic stress disorder (PTSD), both for patients and their caregivers. We investigated correlations between outcomes and population characteristics. RESULTS: Of 50 ICU-survivors, seven died later and five were not contactable. Among 38 living patients, 33 participated (87%, 31 with their caregiver) with 2.7 years of median follow-up. Physical and mental SF-36 component scores were 42 (inter-quartile range, IQR:22) and 52 (IQR:18.5), respectively. The worst domains of the SF-36 were physical-role limitations (25, IQR:100) and general-health perception (56, IQR:42.5). Psychological tests highlighted high risk of depression (39-42%, patients; 39-52%, caregivers), anxiety (42%, patients; 39%, caregivers), and PTSD (47%, patients; 61%, caregivers). Patient depression or anxiety scores were correlated to age and to the outcome reported by caregivers. CONCLUSIONS: At almost three-year follow-up, ARDS survivors treated with VV-ECMO showed reduced health-related quality-of-life and high risk of psychological impairment, in particular PTSD. Caregivers of this population were at high psychological risk as well.
BACKGROUND:Acute respiratory distress syndrome (ARDS) survivors are affected with long-term physical/mental impairments, with improvements limited mostly to the first year after intensive care (ICU) discharge. Furthermore, caregivers of ICU patients exhibit psychological problems after family-member recovery. We evaluated the long-term physical and mental recovery of ARDS survivors treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO), and the long-term psychological impact on their caregivers. METHODS: Single-center prospective evaluation of a retrospective cohort of 75 ARDSpatients treated with VV-ECMO during a seven-year period (25.10.2009-11.08.2016). Primary outcomes were the 36-Item Short-Form Health-Survey (SF-36, patients only), and risks of depression, anxiety or post-traumatic stress disorder (PTSD), both for patients and their caregivers. We investigated correlations between outcomes and population characteristics. RESULTS: Of 50 ICU-survivors, seven died later and five were not contactable. Among 38 living patients, 33 participated (87%, 31 with their caregiver) with 2.7 years of median follow-up. Physical and mental SF-36 component scores were 42 (inter-quartile range, IQR:22) and 52 (IQR:18.5), respectively. The worst domains of the SF-36 were physical-role limitations (25, IQR:100) and general-health perception (56, IQR:42.5). Psychological tests highlighted high risk of depression (39-42%, patients; 39-52%, caregivers), anxiety (42%, patients; 39%, caregivers), and PTSD (47%, patients; 61%, caregivers). Patientdepression or anxiety scores were correlated to age and to the outcome reported by caregivers. CONCLUSIONS: At almost three-year follow-up, ARDS survivors treated with VV-ECMO showed reduced health-related quality-of-life and high risk of psychological impairment, in particular PTSD. Caregivers of this population were at high psychological risk as well.
Authors: E R Kurniawati; V G H Rutjens; N P A Vranken; T S R Delnoij; R Lorusso; I C C van der Horst; J G Maessen; P W Weerwind Journal: Qual Life Res Date: 2021-04-07 Impact factor: 4.147
Authors: Venkatakrishna Rajajee; Christopher Mon-Chee Fung; Katharine Surella Seagly; Pauline Kyonsook Park; Krishnan Raghavendran; David Antonio Machado-Aranda; Jonathan William Scott; Matthew Joseph Delano; Ashraf Shaaban Abdel Aziz Abou El Ela; Jonathan William Haft; Craig Andrew Williamson; Jakob Israel McSparron; Ross Blank; Lena Marie Napolitano Journal: Crit Care Explor Date: 2021-09-10
Authors: Kirby P Mayer; Sarah E Jolley; Eric W Etchill; Shoaib Fakhri; Jordan Hoffman; Carla M Sevin; Joseph B Zwischenberger; Jessica Y Rove Journal: JTCVS Open Date: 2020-11-25