Viktor von Bahr1, Håkan Kalzén1,2, Björn Frenckner2,3, Jan Hultman1,2, K Gunilla Frisén2, Marika K Lidegran4, Sandra Diaz4,5, Maximilian V Malfertheiner6, Jonathan E Millar7, Tanja Dobrosavljevic2, Staffan Eksborg8, Bernhard Holzgraefe2. 1. 1 Section for Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. 2. 2 Department of Pediatric Anaesthesia, Intensive Care and ECMO Services, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 3. 3 Division of Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet and Astrid Lindgren Children's Hospital, Stockholm, Sweden. 4. 4 Department of Pediatric Radiology, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 5. 5 Department of Radiology and Translational Medicine, Lund University and Skane University Hospital, Lund, Sweden. 6. 6 Department of Internal Medicine II, Cardiology and Pneumology, University Medical Center Regensburg, Regensburg, Germany. 7. 7 Department of Anaesthesia, Critical Care & Pain, School of Medicine, University of Glasgow, Glasgow, UK. 8. 8 Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet and Astrid Lindgren Children's Hospital, Stockholm, Sweden.
Abstract
BACKGROUND: There is a significant long-term burden on survivors after acute respiratory distress syndrome, even 5 years after discharge. This is not well investigated in patients treated with extracorporeal membrane oxygenation. The objective of this study was to describe very-long-term (⩾3 years) disability in lung function and morphology, quality of life, mood disorders, walking capacity, and return to work status in extracorporeal membrane oxygenation survivors. METHODS: Single-center retrospective cohort study on long-term survivors treated with extracorporeal membrane oxygenation for respiratory failure between 1995 and 2010 at a tertiary referral center in Sweden. Eligible patients were approached, and those who consented were interviewed and investigated during a day at the hospital. RESULTS: A total of 38 patients were investigated with a median follow-up time of 9.0 years. Quality of life was reduced in several Short form 36 (SF-36) subscales and all domains of the St George's Respiratory Questionnaire, similar to previous studies in conventionally managed acute respiratory distress syndrome survivors. A reduced diffusion capacity of carbon monoxide was seen in 47% of patients, and some degree of residual lung parenchymal pathology was seen in 82%. Parenchymal pathology correlated with reductions in quality of life and diffusion capacity. Symptoms of anxiety and depression were seen in 22% and 14%, respectively. CONCLUSION: A significant long-term burden remains even 3-17 years after extracorporeal membrane oxygenation treatment, similar to conventionally managed acute respiratory distress syndrome survivors. Future prospective studies are needed to elucidate risk factors for these sequelae.
BACKGROUND: There is a significant long-term burden on survivors after acute respiratory distress syndrome, even 5 years after discharge. This is not well investigated in patients treated with extracorporeal membrane oxygenation. The objective of this study was to describe very-long-term (⩾3 years) disability in lung function and morphology, quality of life, mood disorders, walking capacity, and return to work status in extracorporeal membrane oxygenation survivors. METHODS: Single-center retrospective cohort study on long-term survivors treated with extracorporeal membrane oxygenation for respiratory failure between 1995 and 2010 at a tertiary referral center in Sweden. Eligible patients were approached, and those who consented were interviewed and investigated during a day at the hospital. RESULTS: A total of 38 patients were investigated with a median follow-up time of 9.0 years. Quality of life was reduced in several Short form 36 (SF-36) subscales and all domains of the St George's Respiratory Questionnaire, similar to previous studies in conventionally managed acute respiratory distress syndrome survivors. A reduced diffusion capacity of carbon monoxide was seen in 47% of patients, and some degree of residual lung parenchymal pathology was seen in 82%. Parenchymal pathology correlated with reductions in quality of life and diffusion capacity. Symptoms of anxiety and depression were seen in 22% and 14%, respectively. CONCLUSION: A significant long-term burden remains even 3-17 years after extracorporeal membrane oxygenation treatment, similar to conventionally managed acute respiratory distress syndrome survivors. Future prospective studies are needed to elucidate risk factors for these sequelae.
Entities:
Keywords:
acute respiratory distress syndrome; critical care outcomes; extracorporeal membrane oxygenation; health-related quality of life; lung injury; respiratory function tests