• Anesthesiology · Apr 2019

    Observational Study

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

    • Giacomo Grasselli, Vittorio Scaravilli, Daniela Tubiolo, Riccarda Russo, Francesco Crimella, Francesca Bichi, Morlacchi Letizia Corinna LC, Eleonora Scotti, Lorenzo Patrini, Luciano Gattinoni, Antonio Pesenti, and Davide Chiumello.
    • 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.).
    • Anesthesiology. 2019 Apr 1; 130 (4): 572-580.

    BackgroundSurvivors 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.MethodsA 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.ResultsEighty-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.ConclusionsDespite 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.

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