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

Norkienė, Ieva; Jovaiša, Tomas Raimundas; Ščupakova, Nadežda; Janušauskas, Vilius; Ručinskas, Kęstutis; Šerpytis, Pranas; Laurušonis, Kęstutis; Samalavičius, Robertas

doi:10.1177/0267659118815291

Cited by 15 publications

(12 citation statements)

References 20 publications

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“…Fifteen studies (8, 21–24, 26, 29, 31, 32, 34, 36, 37, 44, 47, 48) used the SF-36, of which 13 compared SF-36 results with a general population. Compared with the general population, VA-ECMO survivors experienced worse physical and mental health QOL outcomes across the different domains ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Sounding the Alarm: What Clinicians Need to Know about Physical, Emotional, and Cognitive Recovery After Venoarterial Extracorporeal Membrane Oxygenation*

Higa

Mayer

Quinn

et al. 2023

Critical Care Medicine

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OBJECTIVE: We summarize the existing data on the occurrence of physical, emotional, and cognitive dysfunction associated with postintensive care syndrome (PICS) in adult survivors of venoarterial extracorporeal membrane oxygenation (VA-ECMO). DATA SOURCES: MEDLINE, Cochrane Library, EMBASE, Web of Science, and CINAHL databases were searched. STUDY SELECTION: Peer-reviewed studies of adults receiving VA-ECMO for any reason with at least one measure of health-related quality of life outcomes or PICS at long-term follow-up of at least 6 months were included. DATA EXTRACTION: The participant demographics and baseline characteristics, in-hospital outcomes, long-term health outcomes, quality of life outcome measures, and prevalence of PICS were extracted. DATA SYNTHESIS: Twenty-seven studies met inclusion criteria encompassing 3,271 patients who were treated with VA-ECMO. The studies were limited to single- or two-center studies. Outcomes variables and follow-up time points evaluated were widely heterogeneous which limits comprehensive analysis of PICS after VA-ECMO. In general, the longer-term PICS-related outcomes of survivors of VA-ECMO were worse than the general population, and approaching that of patients with chronic disease. Available studies identified high rates of abnormal 6-minute walk distance, depression, anxiety, and posttraumatic stress disorder that persisted for years. Half or fewer survivors return to work years after discharge. Only 2 of 27 studies examined cognitive outcomes and no studies evaluated cognitive dysfunction within the first year of recovery. No studies evaluated the impact of targeted interventions on these outcomes. CONCLUSIONS: Survivors of VA-ECMO represent a population of critically ill patients at high risk for deficits in physical, emotional, and cognitive function related to PICS. This systematic review highlights the alarming reality that PICS and in particular, neurocognitive outcomes, in survivors of VA-ECMO are understudied, underrecognized, and thus likely undertreated. These results underscore the imperative that we look beyond survival to focus on understanding the burden of survivorship with the goal of optimizing recovery and outcomes after these life-saving interventions. Future prospective, multicenter, longitudinal studies in recovery after VA-ECMO are justified.

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Section: Resultsmentioning

confidence: 99%

Sounding the Alarm: What Clinicians Need to Know about Physical, Emotional, and Cognitive Recovery After Venoarterial Extracorporeal Membrane Oxygenation*

Higa

Mayer

Quinn

et al. 2023

Critical Care Medicine

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“…This proves that the decision to initiate ECMO support should be considered at the early onset of severe post-cardiotomy shock in the elderly patients. Despite lower hospital survival rates among the elderly, patients who survive to discharge have an acceptable long-term survival [ 18 , 19 ], and despite the complex clinical course, they do have satisfactory mental and physical recovery [ 20 ]. Eleven of our patients (85%) were discharged home and two (15%) were transferred to another hospital for extended medical care.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Life Support for Cardiogenic Shock in Octogenarians: Single Center Experience

Ščupakova

Urbonas

Jankuvienė

et al. 2023

JCM

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Background: The age limit for the use of extracorporeal membrane oxygenation (ECMO) support for post-cardiotomy cardiac failure is not defined. The aim of the study was to evaluate the outcomes of octogenarians supported with ECMO due to cardiogenic shock. Methods: A retrospective review of consecutive elderly patients supported with ECMO during a 13-year period in a tertiary care center. Patient’s demographic variables, comorbidities, perioperative data and outcomes were collected from patient medical records. Data of octogenarian patients were compared with the septuagenarian group. The main outcomes of the study was in hospital mortality, 6-month survival and 1-year survival after hospital discharge and discharge options. Multivariate logistic regression analysis was performed to identify the factors associated with hospital survival. Results: Eleven patients (18.3%) in the elderly group were octogenarians (aged 80 years or above), and forty-nine (81.7%) were septuagenarians (aged 70–79 years). There were no differences except age in demographic and preoperative variables between groups. Pre ECMO SAVE, SOFA, SAPS—II and inotropic scores were significantly higher in septuagenarians than octogenarians. There was no statistically significant difference in hospital mortality, 6-month survival, 1 year survival or discharge options between groups. Conclusions: ECMO could be successfully used in selected octogenarian patients undergoing cardiac surgery to support a failing heart. An early decision to initiate ECMO therapy in elderly post-cardiotomy shock patients is associated with favorable outcomes.

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“…A number of studies have assessed HRQoL after ECMO using either the EQ-5D-3L or the SF-36 [ 7 , 10 , 19 , 23 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Their results can be summarized as follows.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival and Quality of Life in Non-Surgical Adult Patients Supported with Veno-Arterial Extracorporeal Oxygenation

Cankar

Krepek

Kosmopoulos

et al. 2022

JCM

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Background: The use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) for hemodynamic support is on the rise. Not much is known about the impact of extracorporeal membrane oxygenation (ECMO) and its complications on long-term survival and quality of life. Methods: In this single-center, cross-sectional study, we evaluated the survival and quality of life in patients treated with VA ECMO between May 2009 and July 2019. Follow-up was conducted between November 2019 and January 2020. Results: Overall, 118 patients were evaluated in this study. Of the 37 patients who were alive at hospital discharge, 32 answered the EuroQol-5 dimensional—5-level questionnaire (EQ-5D-5L). For patients discharged alive from the hospital, mean survival was 8.1 years, 8.4 years for cardiogenic shock, and 5.0 years for patients with refractory cardiac arrest. EQ-5D-5L index value of ECMO survivors was not significantly different from the general age-matched population. Neurologic complications and major bleeding during index hospitalization limit long-term quality of life. Conclusions: Patients treated with VA ECMO have high in-hospital mortality, with extracorporeal membrane oxygenation cardio-pulmonary resuscitation patients being at higher risk of early death. However, once discharged from the hospital, most patients remain alive with a reasonable quality of life.

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

Cited by 15 publications

References 20 publications

Sounding the Alarm: What Clinicians Need to Know about Physical, Emotional, and Cognitive Recovery After Venoarterial Extracorporeal Membrane Oxygenation*

Sounding the Alarm: What Clinicians Need to Know about Physical, Emotional, and Cognitive Recovery After Venoarterial Extracorporeal Membrane Oxygenation*

Extracorporeal Life Support for Cardiogenic Shock in Octogenarians: Single Center Experience

Long-Term Survival and Quality of Life in Non-Surgical Adult Patients Supported with Veno-Arterial Extracorporeal Oxygenation

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