严重急性呼吸窘迫综合征患者行静脉-静脉体外膜肺氧合支持的长期生存和健康相关生活质量。
Long-term survival and health-related quality of life in patients with severe acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation support.
机构信息
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
出版信息
Crit Care. 2021 Nov 29;25(1):410. doi: 10.1186/s13054-021-03821-0.
BACKGROUND
There is limited information about the long-term outcome of patients suffering from acute respiratory distress syndrome (ARDS) supported with veno-venous extracorporeal membrane oxygenation (VV ECMO). Most studies focused on short- to mid-term follow-up. We aimed to investigate long-term survival and health-related quality of life (HRQL) in these patients.
METHODS
We report retrospective data from a single-centre registry of patients with severe ARDS treated with VV ECMO at the Interdisciplinary Medical Intensive Care Unit at the Medical Centre, University of Freiburg, Germany, between 10/2010 and 06/2019. Follow-up data of all patients that survived the index hospitalisation were collected by telephone interviews from 02/2020 till 09/2020. Long-term survival, HRQL (Short-Form Health Survey-36 (SF-36), St. Georges Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS)) and the return to work rate were documented.
RESULTS
In total, 289 patients were treated with VV ECMO during the study period (median age 55 years, 67% males, hospital survival 45%). After a median duration of 3.9 years, follow-up assessment was complete in 94 of 129 hospital survivors (73%). Fifty-three patients completed the HRQL assessment. Hospital survivors showed a high 6- and 12-month survival rate (89% and 85%, respectively). Estimated survival rate of those discharged alive from ICU was 68.5% (95%-CI 56.9-80.1%) after 9.7 years. These patients reported high levels of HRQL (median SF-36 total score 73) and only few pulmonary (median SGRQ total score 19) and mental limitations (median HAD-D score 2 and HAD-A score 3). In total, 80% of the patients were able to resume employment.
CONCLUSION
This analysis of VV ECMO patients showed favourable long-term survival and high levels of HRQL suggesting promising prospects for VV ECMO survivors.
背景
关于接受静脉-静脉体外膜肺氧合（VV ECMO）支持的急性呼吸窘迫综合征（ARDS）患者的长期预后信息有限。大多数研究都集中在短期至中期随访。我们旨在调查这些患者的长期生存率和健康相关生活质量（HRQL）。
方法
我们报告了来自德国弗赖堡大学医学中心多学科重症监护病房 VV ECMO 治疗严重 ARDS 患者的单一中心登记处的回顾性数据，该研究于 2010 年 10 月至 2019 年 6 月进行。通过电话采访收集了所有在索引住院期间存活下来的患者的随访数据，从 2020 年 2 月至 2020 年 9 月。记录了长期生存率、HRQL（36 项简短健康调查（SF-36）、圣乔治呼吸问卷（SGRQ）、医院焦虑和抑郁量表（HADS））和重返工作率。
结果
在研究期间，共有 289 例患者接受了 VV ECMO 治疗（中位年龄 55 岁，67%为男性，医院存活率为 45%）。中位随访 3.9 年后，129 例住院幸存者中有 94 例完成了随访评估（73%）。53 例患者完成了 HRQL 评估。住院幸存者在 6 个月和 12 个月时的生存率均较高（分别为 89%和 85%）。存活出院至 ICU 的患者在 9.7 年后的估计生存率为 68.5%（95%-CI 56.9-80.1%）。这些患者报告了较高的 HRQL（中位 SF-36 总分 73），仅有较少的肺部（中位 SGRQ 总分 19）和精神受限（中位 HADS-D 评分 2 和 HADS-A 评分 3）。总体而言，80%的患者能够恢复工作。
结论
对 VV ECMO 患者的这项分析显示出有利的长期生存率和较高的 HRQL，这表明 VV ECMO 幸存者前景乐观。
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