Long-term quality of life in patients treated with extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock

Abstract

Objective:

The aim of our study was to explore long-term health-related quality of life (HRQOL) and incidence of post-traumatic stress disorder (PTSD) in extracorporeal membrane oxygenation (ECMO) survivors.

Methods:

Single-center prospective follow-up study. All patients in whom ECMO was initiated due to refractory cardiogenic shock between 2009 and 2014 were included in the study. We used Medical Outcomes Study 36-Item Short-Form Health Survey to evaluate HRQOL and IES-R questionnaire to assess incidence of PTSD.

Results:

Sixty-nine patients were treated with venoarterial (VA) ECMO during the study period. Nineteen patients survived until hospital discharge and 15 patients were alive at the study cut-off point in June 2017; mean follow-up time was 70.6 ± 10 months. The average Physical Component Summary and Mental Component Summary scores amongst long-term survivors were 46.1 ± 7 and 47.1 ± 8, respectively. PTSD was evident in 4 out of 15 participants.

Conclusions:

Despite the complex clinical course and prolonged recovery, ECMO survivors achieved satisfactory levels of both mental and physical recovery, which were comparable to the age- and pathology-adjusted population means.

Keywords

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References

Tramm

Ilic

Davies

Pellegrino

Romero

Hodgson

Extracorporeal membrane oxygenation for critically ill adults. Cochrane Database Syst Rev 2015; 1: CD010381.

McCarthy

McDermott

Kini

et al . Trends in US extracorporeal membrane oxygenation use and outcomes: 2002–2012. Semin Thorac Cardiovasc Surg 2015; 27: 81–88.

Hodgson

Hayes

Everard

et al . Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia. Crit Care 2012; 16: R202.

Bakhtiary

Keller

Dogan

et al . Venoarterial extracorporeal membrane oxygenation for treatment of cardiogenic shock: clinical experiences in 45 adult patients. J Thorac Cardiovasc Surg 2008; 135: 382–388.

Aubron

Cheng

Pilcher

et al . Factors associated with outcomes of patients on extracorporeal membrane oxygenation support: a 5-year cohort study. Crit Care 2013; 17: R73.

Muller

Flecher

Lebreton

et al . The ENCOURAGE mortality risk score and analysis of long-term outcomes after VA-ECMO for acute myocardial infarction with cardiogenic shock. Intensive Care Med 2016; 42: 370–378.

Harvey

Davidson

JE.

Postintensive care syndrome: right care, right now…and later. Crit Care Med 2016; 44: 381–385.

Svenningsen

Langhorn

Agard

et al . Post-ICU symptoms, consequences, and follow-up: an integrative review. Nurs Crit Care 2017; 22: 212–220.

Desai

Law

Needham

. Long-term complications of critical care. Crit Care Med 2011; 39: 371–379.

10.

Combes

Leprince

Luyt

et al . Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med 2008; 36: 1404–1411.

11.

Ware

Sherborne

CD.

The MOS 36-iItem short-form health survey (SF-36). Med Care 1992; 30: 473–483.

12.

Norkienė

Urbanaviciute

Kezyte

et al . Impact of pre-operative health-related quality of life on outcomes after heart surgery. ANZ J Surg 2018; 88: 332–336.

13.

Creamer

Bell

Failla

Psychometric properties of the impact of event scale-revised. Behav Res Ther 2003; 41: 1489–1496.

14.

Staniute

Bunevicius

Brozaitiene

et al . Relationship of health-related quality of life with fatigue and exercise capacity in patients with coronary artery disease. Eur J Cardiovasc Nurs 2014; 13: 338–344.

15.

Wang

Han

Jia

et al . Early and intermediate results of rescue extracorporeal membrane oxygenation in adult cardiogenic shock. Ann Thorac Surg 2009; 88: 1897–1903.

16.

Doll

Kiaii

Borger

et al . Five year results of 219 consecutive patients treated with extracorporeal membrane oxygenation after refractory postoperative cardiogenic shock. Ann Thorac Surg 2004; 77: 151–157.

17.

Rastan

Dege

Mohr

et al . Early and late outcomes of 517 consecutive adult patients treated with extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock. J Thorac Cardiovasc Surg 2010; 139: 302–311.

18.

Ratzer

Romano

Elklit

Posttraumatic stress disorder in patients following intensive care unit treatment: a review of studies regarding prevalence and risk factors. J Trauma Treat 2014; 3: 190.