Newly Published
Critical Care Medicine  |   February 2019
Quality of Life and Lung Function in Survivors of Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome
Author Notes
  • From the Department of Anesthesia, Critical Care, and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda - Ospedale Maggiore Policlinico, Milan (MI), Italy (G.G., V.S., D.T., R.R., A.P.); Department of Pathophysiology and Transplantation, University of Milan, Milan (MI), Italy (G.G., F.C., F.B., L.C.M., E.S., A.P.); Department of Preventive Medicine, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda - Ospedale Maggiore Policlinico, Milan (MI), Italy (L.P.); Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany (L.G.); Department of Health Sciences, University of Milan, Milan (MI), Italy (D.C.).
  • Submitted for publication April 28, 2018. Accepted for publication December 10, 2018.
    Submitted for publication April 28, 2018. Accepted for publication December 10, 2018.×
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • G.G. and V.S. equally contributed to the study.
    G.G. and V.S. equally contributed to the study.×
  • Correspondence: Address correspondence to Dr. Grasselli: Department of Anesthesia, Critical Care, and Emergency, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan (MI), Italy. giacomo.grasselli@unimi.it. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Critical Care Medicine / Critical Care / Respiratory System / Thoracic Anesthesia
Critical Care Medicine   |   February 2019
Quality of Life and Lung Function in Survivors of Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome
Anesthesiology Newly Published on February 8, 2019. doi:10.1097/ALN.0000000000002624
Anesthesiology Newly Published on February 8, 2019. doi:10.1097/ALN.0000000000002624
Abstract

Editor’s Perspective:

What We Already Know about This Topic:

  • Extracorporeal membrane oxygenation is used in severe acute respiratory distress syndrome; whereas the long-term complications among survivors of acute respiratory distress syndrome treated without extracorporeal membrane oxygenation are well described, the status of extracorporeal membrane oxygenation survivors is poorly understood

What This Article Tells Us That Is New:

  • In a single-center cohort of acute respiratory distress syndrome survivors, management with (vs. without) extracorporeal membrane oxygenation resulted in similar survival at 1 yr, pulmonary function, and computed tomography lung imaging, but less impairment in quality of life

Background: Survivors of acute respiratory distress syndrome (ARDS) have long-term impairment of pulmonary function and health-related quality of life, but little is known of outcomes of ARDS survivors treated with extracorporeal membrane oxygenation. The aim of this study was to compare long-term outcomes of ARDS patients treated with or without extracorporeal membrane oxygenation.

Methods: A prospective, observational study of adults with ARDS (January 2013 to December 2015) was conducted at a single center. One year after discharge, survivors underwent pulmonary function tests, computed tomography of the chest, and health-related quality-of-life questionnaires.

Results: Eighty-four patients (34 extracorporeal membrane oxygenation, 50 non–extracorporeal membrane oxygenation) were studied; both groups had similar characteristics at baseline, but comorbidity was more common in non–extracorporeal membrane oxygenation (23 of 50 vs. 4 of 34, 46% vs. 12%, P < 0.001), and severity of hypoxemia was greater in extracorporeal membrane oxygenation (median Pao2/Fio2 72 [interquartile range, 50 to 103] vs. 114 [87 to 133] mm Hg, P < 0.001) and respiratory compliance worse. At 1 yr, survival was similar (22/33 vs. 28/47, 66% vs. 59%; P = 0.52), and pulmonary function and computed tomography were almost normal in both groups. Non–extracorporeal membrane oxygenation patients had lower health-related quality-of-life scores and higher rates of posttraumatic stress disorder.

Conclusions: Despite more severe respiratory failure at admission, 1-yr survival of extracorporeal membrane oxygenation patients was not different from that of non–extracorporeal membrane oxygenation patients; each group had almost full recovery of lung function, but non–extracorporeal membrane oxygenation patients had greater impairment of health-related quality of life.