Correspondence  |   November 2019
Extracorporeal Membrane Oxygenation 1-yr Outcome: Reply
Author Notes
  • Fondazione IRCCS Ca’ Granda Policlinico Hospital, and the University of Milan, Milan, Italy. giacomo.grasselli@unimi.it
  • (Accepted for publication August 12, 2019.)
    (Accepted for publication August 12, 2019.)×
Article Information
Correspondence
Correspondence   |   November 2019
Extracorporeal Membrane Oxygenation 1-yr Outcome: Reply
Anesthesiology 11 2019, Vol.131, 1196-1197. doi:10.1097/ALN.0000000000002970
Anesthesiology 11 2019, Vol.131, 1196-1197. doi:10.1097/ALN.0000000000002970
We thank Drs. Phillips and Fink for their interest in our work1 and we completely agree with all their observations. Through the years, we have assisted with continuous significant advancements in the care of critically ill patients. Better management of mechanical ventilation and sepsis, advanced monitoring techniques, and more recently, extracorporeal life support techniques, all contributed to improve the rate of survival of critical illness. There is also a tendency to admit older patients with more comorbidities to intensive care units (ICU). At the same time, however, we are realizing that being discharged alive from ICU might not be “the last stage of the journey,” but rather, the beginning of an even longer and potentially more painful ordeal. Indeed, ICU survivors experience not only the direct consequences of the critical illness, but also significant long-term outcomes including physical weakness, neurocognitive impairment, and psychiatric disorders that, in turn, significantly affect their quality of life.2  Moreover, families and caregivers are also at increased risk for psychologic sequelae, particularly posttraumatic stress disorder. Hence, in critical patients, long-term mortality, morbidity, and quality of life may be considered more meaningful outcomes than short-term mortality.3