Long-Term Quality of Life After Extracorporeal Membrane Oxygenation in ARDS Survivors: Systematic Review and Meta-Analysis

M.Elizabeth Wilcox, Valente Jaramillo-Rocha, Carol Hodgson, Michael S. Taglione, Niall D. Ferguson, Eddy Fan

Research output: Contribution to journalArticleResearchpeer-review

16 Citations (Scopus)

Abstract

Purpose: Extracorporeal membrane oxygenation (ECMO) is an increasingly prevalent treatment for acute respiratory failure (ARF). To evaluate the impact of ECMO support on long-term outcomes for critically ill adults with ARF. Methods: We searched electronic databases 1948 through to November 30 2016; selected controlled trials or observational studies of critically ill adults with acute respiratory distress syndrome, examining long-term morbidity specifically health-related quality of life (HRQL); 2 authors independently selected studies, extracted data, and assessed methodological quality. Analysis: Of the 633 citations, 1 randomized controlled trial and 5 observational studies met the selection criteria. Overall quality of observational studies was moderate to high (mean score on Newcastle-Ottawa scale, 7.2/9; range, 6-8). In 3 studies (n = 245), greater decrements in HRQL were seen for survivors of ECMO when compared to survivors of conventional mechanical ventilation (CMV) as measured by the Short Form 36 (SF-36) scores ([ECMO-CMV]: 5.40 [95% confidence interval, CI, 4.11 to 6.68]). As compared to CMV survivors, those who received ECMO experienced significantly less psychological morbidity (2 studies; n = 217 [ECMO-CMV]: mean weighted difference [MWD], −1.31 [95% CI, −1.98 to −0.64] for depression and MWD, −1.60 [95% CI, −1.80 to −1.39] for anxiety). Conclusions: Further studies are required to confirm findings and determine prognostic factors associated with more favorable outcomes in survivors of ECMO.

Original languageEnglish
Pages (from-to)233-243
Number of pages11
JournalJournal of Intensive Care Medicine
Volume35
Issue number3
DOIs
Publication statusPublished - Mar 2020

Keywords

  • ECMO
  • extracorporeal membrane oxygenation
  • health-related quality of life
  • outcome assessment (health care)
  • respiratory distress syndrome

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