Experiences of adult extracorporeal membrane oxygenation patients following discharge: A mixed methods study

Savaş, Hafize; Köken, Zeliha Özdemir; Çelik, Sevilay Şenol

doi:10.1016/j.hrtlng.2020.03.009

Cited by 6 publications

(20 citation statements)

References 30 publications

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“…These complications are relevant for the short-and longterm outcome. In the long-term, major physical complications may still severely impact the patient and their family [20,21]. Although intensive rehabilitation could improve long-term outcome, some complications still have a major, irreversible long-term impact.…”

Section: Impact On Family and Patientmentioning

confidence: 99%

Do-(Not-)Mechanical-Circulatory-Support Orders: Should We Ask All Cardiac Surgery Patients for Informed Consent for Post-Cardiotomy Extracorporeal Life Circulatory Support?

Simons

Suverein

Mook

et al. 2021

JCM

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Post-cardiotomy extracorporeal life support (PC-ECLS) has seen a substantial increase in use over the past 10 years. PC-ECLS can be a life-saving procedure and is mostly applied in the presence of unexpected, severe cardio-respiratory complication. Despite PC-ECLS being critical in allowing for organ recovery, it is unfortunately closely connected with an unpredictable outcomes, high morbidity, and, even in the case of cardiac function improvement, potential sustained disabilities that have a life-changing impact for the patient and his or her family. Since the decision to start PC-ECLS is made in an acute setting, there is often only limited or no time for self-determined choices. Due to the major impact of the intervention, it would be highly desirable to obtain informed consent before starting PC-ECLS, since the autonomy of the patient and shared-decision making are two of the most important ethical values in modern medicine. Recent developments regarding awareness of the impacts of a prolonged intensive care stay make this a particularly relevant topic. Therefore, it would be desirable to develop a structural strategy that takes into account the likelihood of such an intervention and the wishes and preferences of the patient, and thus the related autonomy of the patient. This article proposes key points for such a strategy in the form of a PC-ECLS informed consent, a do-(not-)mechanical-circulatory-support order (D(N)MCS), and specific guidelines to determine the extent of the shared decision making. The concept presented in this article could be a starting point for improved and ethical PC-ECLS treatment and application.

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Section: Impact On Family and Patientmentioning

confidence: 99%

Do-(Not-)Mechanical-Circulatory-Support Orders: Should We Ask All Cardiac Surgery Patients for Informed Consent for Post-Cardiotomy Extracorporeal Life Circulatory Support?

Simons

Suverein

Mook

et al. 2021

JCM

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“…15 One study used a mixed-method convergent parallel design. 16 Six studies collected data using semi-structured or in-depth interviews. [8][9][10]12,14,16 One study collected data using observations and interviews, 13 and another used interviews and documents.…”

Section: Study Design Data Collection and Data Analysismentioning

confidence: 99%

“…16 Six studies collected data using semi-structured or in-depth interviews. [8][9][10]12,14,16 One study collected data using observations and interviews, 13 and another used interviews and documents. 11 One study collected data using focus groups.…”

Section: Study Design Data Collection and Data Analysismentioning

confidence: 99%

“…15 Four studies analyzed their data using thematic analysis. [8][9][10]15 One study each used the following: descriptive abductive, 13 content analysis, 11 qualitative descriptive, 16 Miles and Huberman's 3-phased analysis, 12 and grounded theory. 14…”

Section: Study Design Data Collection and Data Analysismentioning

confidence: 99%

“…Of the 9 included studies, 3 were conducted in Australia, 9,10,15 2 were conducted in the US, 11,13 and 1 each in the State of Kuwait, 8 Turkey, 16 Taiwan, 12 and UK. 14…”

Section: Country Of Originmentioning

confidence: 99%

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Extracorporeal Membrane Oxygenation for Adults and Children With Severe Respiratory Failure

Smith¹,

Loshak²

2021

cjht

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This review used a framework analysis to synthesize 9 included studies on the perspectives and experiences of patients, family members, and providers on extracorporeal membrane oxygenation (ECMO). Patients’ perspectives on their experiences are limited due to their sedated status when treated with ECMO. Supporting a relative treated with ECMO is stressful for family members. They feel anxious and worried about their relative because of the patient’s critical condition, and they struggle to juggle multiple roles at work and home while supporting their relative receiving ECMO. Family members often have to travel to see their critically ill relative. Financial and logistical support for temporary relocation near the ECMO centre may ease the burden of travel. Family members benefit from clear and frequent communication from health care providers as a source of support and reassurance while their loved ones are being treated with ECMO. There may be a role for informal or formal peer support for family members of patients receiving ECMO. Clinicians’ decisions to offer, continue, and withdraw ECMO are based on their assessments of prognostic factors from patients’ medical histories and clinical conditions. Additional clinical research and/or refinements of prognostic guidance for ECMO may further support evidence-informed decision-making around ECMO. Patients, family members, and clinical team members may differ in their assessment of the limits of ECMO treatment and the decision to transition from active treatment to the withdrawal of life support. These findings point to the role of ethical considerations and processes when engaging in transitioning to end-of-life support in the provision of ECMO. After discharge, patients who had received ECMO and their family members continued to have feelings of anxiety, intrusive thoughts, and a need to process the event. ECMO programs that can offer continued or ongoing support or referral for patients and their family members’ mental health may help address these needs.

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The lived experience by patients and family members of extracorporeal membrane oxygenation: A qualitative study

Minion

Mastikhina

Dowsett

et al. 2022

Intensive and Critical Care Nursing

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Experiences of adult extracorporeal membrane oxygenation patients following discharge: A mixed methods study

Cited by 6 publications

References 30 publications

Do-(Not-)Mechanical-Circulatory-Support Orders: Should We Ask All Cardiac Surgery Patients for Informed Consent for Post-Cardiotomy Extracorporeal Life Circulatory Support?

Do-(Not-)Mechanical-Circulatory-Support Orders: Should We Ask All Cardiac Surgery Patients for Informed Consent for Post-Cardiotomy Extracorporeal Life Circulatory Support?

Extracorporeal Membrane Oxygenation for Adults and Children With Severe Respiratory Failure

The lived experience by patients and family members of extracorporeal membrane oxygenation: A qualitative study

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