Long-term survival and quality of life after extracorporeal membrane oxygenation

Objectives: Long-term data on patient survivors after extracorporeal membrane oxygenation (ECMO) support remains limited. This study sought to examine the 5-year survival and health-related quality of life (HRQoL) of patients treated with venoarterial (VA)-or venovenous (VV)-ECMO. Methods: A single-center retrospective chart review and survival analysis was con-ducted on all patients who required ECMO from December 2007 to June 2019. Cross-sectional HRQoL assessments were performed using 8 standardized ques-tionnaires among survivors. Results: Records for 370 ECMO patients (288 VA-ECMO, 82 VV-ECMO) were re-viewed. Survival at 5 years was 33% (VA-ECMO) and 36% (VV-ECMO). Among pa-tients that survived to 30 days, 5-year survival rates were 73% (VA-ECMO) and 71% (VV-ECMO). Sixty surviving patients (56%) had HRQoL assessments (48 VA-ECMO, 12 VV-ECMO). Median follow-up time was 4.2 (VA-ECMO) and 5.7 years (VV-ECMO). Fourteen (29%) VA-ECMO patients and 9 (75%) VV-ECMO patients reported dif-ficulty with any activity of daily living whereas 13 (27%) VA-ECMO patients and 8 (67%) VV-ECMO patients reported difficulty with any instrumental activity of daily living. Eleven (23%) VA-ECMO patients and 7 (58%) VV-ECMO patients reported a high post-traumatic stress disorder score. Low decision regret scores in both co-horts indicated minimal regret that ECMO was initiated. Conclusions: Five-year clinical and patient-centered outcomes of patients requiring ECMO support is acceptable in those who survived the initial 30 days. Among ECMO survivors, persistent HRQoL concerns were apparent, highlighting the importance of longer-term postdischarge follow-up. (J Thorac Cardiovasc

Automated summary

This study examined the 5-year survival and health-related quality of life (HRQoL) of patients treated with venoarterial (VA)- or venovenous (VV)-ECMO. The study found that the 5-year survival rates for patients who survived the initial 30 days were 73% (VA-ECMO) and 71% (VV-ECMO). Some survivors had persistent HRQoL concerns, highlighting the importance of longer-term post-discharge follow-up.