Department of Cardiothoracic Surgery, Maastricht University Medical Center+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, the Netherlands.
Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
Qual Life Res. 2021 Aug;30(8):2123-2135. doi: 10.1007/s11136-021-02834-0. Epub 2021 Apr 7.
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been used successfully for the past decade in adult patients with acute respiratory distress syndrome (ARDS) refractory to conventional ventilatory support. However, knowledge of the health-related quality of life (HRQoL) in VV-ECMO patients is still limited. Thus, this study aimed to provide a comprehensive overview of the HRQoL following VV-ECMO support in ARDS patients.
A systematic search was performed on PubMed and Web of Science databases from January 1st, 2009 to October 19th, 2020. Studies reporting on HRQoL following VV-ECMO for ARDS in adults were included. Two authors independently selected studies, extracted data, and assessed methodological quality.
Eight studies were eligible for inclusion, consisting of seven observational studies and one randomized controlled trial (total N = 441). All eight studies had a quantitative design and reported 265 VV-ECMO survivors to have a reduced HRQoL compared to a generally healthy population. Follow-up time varied between six months to three years. Additionally, only four studies (total N = 335) compared the HRQoL of VV-ECMO (N = 159) to conventionally treated survivors (N = 176), with one study showing a significantly better HRQoL in VV-ECMO survivors, while three studies were stating comparable HRQoL across groups. Notably, most survivors in these studies appeared to experience varying degrees of anxiety, depression, and post-traumatic stress disorder (PTSD).
ARDS survivors supported by VV-ECMO have a decline in HRQoL and suffered from physical and psychological impairments. This HRQoL reduction is comparable or even better to the HRQoL in conventionally treated ARDS survivors.
在过去的十年中，静脉-静脉体外膜肺氧合（VV-ECMO）已成功用于对常规通气支持无反应的急性呼吸窘迫综合征（ARDS）成人患者。然而，关于 VV-ECMO 患者的健康相关生活质量（HRQoL）的知识仍然有限。因此，本研究旨在提供 ARDS 患者接受 VV-ECMO 支持后的 HRQoL 的综合概述。
对 2009 年 1 月 1 日至 2020 年 10 月 19 日期间的 PubMed 和 Web of Science 数据库进行了系统搜索。纳入报告成人 ARDS 接受 VV-ECMO 后 HRQoL 的研究。两名作者独立选择研究、提取数据并评估方法学质量。
有 8 项研究符合纳入标准，包括 7 项观察性研究和 1 项随机对照试验（总 N=441）。所有 8 项研究均采用定量设计，报告与一般健康人群相比，265 名 VV-ECMO 幸存者的 HRQoL 降低。随访时间从 6 个月到 3 年不等。此外，只有 4 项研究（总 N=335）比较了 VV-ECMO（N=159）与常规治疗幸存者（N=176）的 HRQoL，其中 1 项研究表明 VV-ECMO 幸存者的 HRQoL 显著更好，而 3 项研究表明两组间 HRQoL 相当。值得注意的是，这些研究中的大多数幸存者似乎都经历了不同程度的焦虑、抑郁和创伤后应激障碍（PTSD）。
接受 VV-ECMO 支持的 ARDS 幸存者的 HRQoL 下降，并且存在身体和心理损伤。这种 HRQoL 降低与常规治疗的 ARDS 幸存者的 HRQoL 相当甚至更好。
