Article of the Month – November 2019

Quality of Life and Lung Function in Survivors of Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome

URL: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2724942

DOI: doi:10.1097/ALN.0000000000002624

Published: Anesthesiology. 4 2019, Vol.130, 572-580.

Authors: G. Grasselli, V. Scaravilli, D. Tubiolo, R. Russo, F. Crimella, F. Bichi, L.C. Morlacchi, E. Scotti, L. Patrini, L. Gattinoni, A. Pesenti, D. Chiumello

Article Description:

  • Extracorporeal membrane oxygenation (ECMO) has been established for treating patients with refractory hypoxaemia secondary to severe acute respiratory distress syndrome (ARDS); whereas the long-term outcomes of those patients were not well-studied.
  • The present study aimed to compare the outcomes of patients treated with ECMO with those treated with conventional ventilation in terms of the 1-yr outcomes concerning respiratory function, quantitative pulmonary imaging, and health-related quality of life.

Summary:

  • Eighty-four patients with ARDS were included in the present prospective, longitudinal, cohort observation study during two years.
  • Survival of ECMO patients was higher but not significantly different from that of non–ECMO patients (66% vs. 59%, odds ratio 1.35 [0.54 to 3.50], P = 0.517)
  • Compared with the patients treated with only conventional ventilation, patients supported with ECMO had almost full recovery of respiratory function and lung morphology.
  • Non–ECMO patients had greater impairment of health-related quality of life. That might be explained with the fact that the ECMO patients receive better medical, paramedical and psychologic support than the standard treatment (g., nutrition, wound care, physical therapy) or the fact that ECMO, allowing ultra-protective ventilation may reduce the risk of polyneuropathy or myopathy associated with mechanical ventilation. Contradictory, in the present study ECMO patients had longer duration of mechanical ventilation. Moreover, better health-related quality of life at follow-up for extracorporeal membrane oxygenation patients maybe attributable to particular care that.
  • The present study was conducted at a highly specialised unit at a single centre which could not be extrapolated to other worldwide centres.
  • Few patients were studied in the present study.

Check this interesting study and look for the results: would this be a plus or change your practice? 

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