Mani Latifi, MD
Staff
Cleveland Clinic Foundation
Cleveland, Ohio, United States
Disclosure information not submitted.
Lin Chen, BA
Medical Student
Case Western School of Medicine, United States
Disclosure information not submitted.
Vivian Hua, BA
Medical Student
Case Western School of Medicine, United States
Disclosure information not submitted.
Charles Lane, MD
Assistant Professor
Cleveland Clinic, United States
Disclosure information not submitted.
Eduardo Mireles-Cabodevila, MD
Director , Medical Intensive Care Unit
Cleveland Clinic - Respiratory Institute
Cleveland, Ohio
Disclosure information not submitted.
Leslie Tolle, MD
Assistant Professor
Cleveland Clinic, United States
Disclosure information not submitted.
Abhijit Duggal, MD, MPH, MSc, FACP
Assistant Professor
Cleveland Clinic Foundation, United States
Disclosure information not submitted.
Sudhir Krishnan, MD
Pulmonary and Critical Care Medicine Attending
Cleveland Clinic, Ohio, United States
Disclosure information not submitted.
Title: ECMO Survivor’s Clinic: Assessment of Psychological and Pulmonary Function in VV ECMO Survivors
Introduction: We developed a post VV-ECMO survivor’s clinic to better understand and predict contributing factors to long term outcomes in patients successfully weaned from VV ECMO and discharged from the hospital.
Methods: Prospective observational study: ECMO survivor’s (N=12 ) presenting to a Specialist OP clinic (1-3 months post hospital discharge and then at 1 year). Clinical assessment included full pulmonary function testing & 6 minute walk test. Survey assessments were administered with the use of the HAM-A, PHQ-9 and HCQROL-14.
Results: A total of 12 patients without pulmonary comorbidities prior to ECMO were assessed from 2018-2019. The mean age was 35.8. The mean anxiety score on HAM-A was 12.3 (0-30). Two patients each scored in the moderate and severe range. The mean PHQ-9 (depression) score was 7.0. Ranges 0-12. Two scored in the mild and 3 in the moderate range. Only 1 patient reported their overall health as poor. Two patients had a TLC that was reduced (restrictive defect) while 2 had FEV1/FVC below the LLN consistent with obstruction. All patients had 6 minute walk tests below LLN (Ranges 40-74% predicted).
Conclusions: Post ECMO survivors have significant psychological and physical deficits that impact their quality of life as well as functional capacity. Majority of patients report signs consistent with post-ICU syndrome with a significant recollection of delirious events. Despite the significant psychological and physical limitations in the setting of recent severe critical illness, all but one patient described their overall health at least good. Coordination of care to ancillary services to support the psychological and pulmonary deficits is paramount to address patient care needs to full recovery beyond the inciting respiratory failure.