Obaid Ashraf, MD
Fellow Physician
Allegheny Health System, United States
Disclosure information not submitted.
Subbarao Elapavaluru, MD,
Medical Director of Allegheny General Hospital ECMO Program
Allegheny General Hospital, United States
Disclosure information not submitted.
Michael Collins, MD
Surgical Director of Allegheny General Hospital ECMO Program
Allegheny General Hospital, United States
Disclosure information not submitted.
Manreet Kawar, MD
Physician
Allegheny Health Network, United States
Disclosure information not submitted.
Srinivas Murali, MD, FACC, FCCP, FACP
Physician
Allegheny Health Network, United States
Disclosure information not submitted.
Title: Long-Term Health-Related Quality of Life After Venovenous Extracorporeal Membrane Oxygenation
Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a temporary mechanical support utilized in life-threatening refractory respiratory failure which has failed conventional treatments. Survival to discharge after VV-ECMO support is variably reported at 51-68%. However, long-term prognosis and quality of life among those discharge alive is less well reported. We conducted a retrospective observational review of VV ECMO survivors discharged from our program.
Methods: There were 52 consecutive VV-ECMO survivors discharged between January 2019 to 2020. Electronic Medical Record (EMR) review, in conjunction with phone interview to ascertain the current status (up to Feb 2021) was performed. In addition, information about patients’ physical status to ascertain if they achieved full return to pre-VV ECMO baseline, presence or absence of associated comorbidities, and ECMO related complications was obtained.
Results: Of the 52 patients discharged alive, 3 were lost to follow-up. At the time of contact (Mean 15 +/- 2 months from discharge), 23 patients (47%) were alive, and 26 (53%) were deceased. In the overall cohort, 13 patients (26%) reported full physical recovery, although in 4 of the patients other health problems developed after full recovery. In 16 (33%) patients, health problems continued after discharge. Among the “current” 23 survivors, 13 (57%) patients reported full physical recovery, 7 (30%) patients reported on-going health problems unrelated to VV ECMO, and 3 (13%) patients reported health problems related to VV ECMO, including necrotic digits, and heels, gangrene related amputation, groin and leg pains, and continued need for walking aids.
Conclusion: These observations provide important insight into the long-term clinical outcomes among discharge survivors of VV ECMO support. Long-term survival was 47%, with full physical recovery observed in 26% of patients. Among long-term survivors, full physical recovery was noted in 57%, and VV ECMO related complications in 13% of patients. Further large, longitudinal studies are required to assess the long-term physical, functional, and psychological components of health-related quality of life among VV ECMO discharge survivors.