Ursu Eunicia, Mikolić Ana, Tong Bobo, Silverberg Noah D, Parag Nishtha, Foster Denise, Sekhon Mypinder S, Panenka William, Thiara Sonny, Griesdale Donald E G
Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada.
Department of Psychology, The University of British Columbia, Vancouver, BC, Canada.
Can J Anaesth. 2025 May 29. doi: 10.1007/s12630-025-02965-9.
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly being used in patients with respiratory failure. The goal of this study was to characterize postdischarge psychological and functional outcomes of this patient population.
We conducted a historical cohort study of survivors who required VV-ECMO during the COVID-19 pandemic. Using telephone interviews, we assessed the following domains: disability (using the World Health Organization Disability Schedule [WHODAS 2.0] and modified Rankin Scale [mRS]), health-related quality of life (using the European Quality of Life 5 Dimensions 5 Level tool), cognition (using the telephone Montreal Cognitive Assessment tool), depression (using the Patient Health Questionnaire-9), and posttraumatic stress disorder symptoms (using the Impact of Event Scale-6). We used descriptive statistics to analyze our results.
Twenty-six participants with a median [interquartile range (IQR)] age of 47 [42-59] yr and 6 (23%) of whom were female were evaluated at a median [IQR] of 22 [17-23] months after ECMO separation. Twenty-two (85%) had a diagnosis of COVID-19. The median [IQR] WHODAS 2.0 score was 26 [15-30] with the highest degree of disability in the mobility and participation domains. Of the 24 participants who were employed full-time, 12 (50%) were able to work in the same capacity. Of the 25 respondents who were living independently at baseline, 22 (88%) maintained complete independence for their activities of daily living (mRS < 3), one (4%) described persistent functional limitations (mRS = 3), and two (8%) required constant care (mRS = 4 or 5). Thirteen (52%) and nine (38%) reported at least moderate pain or anxiety, respectively. Ten (40%) and seven (28%) participants screened positive for symptoms of depression or posttraumatic stress disorder, respectively.
Patients who required VV-ECMO experienced significant functional disability, pain, cognitive challenges, mental health problems, and lower quality of life approximately two years after discharge.
静脉-静脉体外膜肺氧合（VV-ECMO）在呼吸衰竭患者中的应用越来越广泛。本研究的目的是描述这一患者群体出院后的心理和功能结局。
我们对在新冠疫情期间需要VV-ECMO的幸存者进行了一项历史性队列研究。通过电话访谈，我们评估了以下领域：残疾情况（使用世界卫生组织残疾评定量表[WHODAS 2.0]和改良Rankin量表[mRS]）、健康相关生活质量（使用欧洲生活质量5维度5水平工具）、认知功能（使用电话版蒙特利尔认知评估工具）、抑郁情况（使用患者健康问卷-9）以及创伤后应激障碍症状（使用事件影响量表-6）。我们使用描述性统计分析结果。
26名参与者接受了评估，他们的年龄中位数[四分位间距（IQR）]为47[42 - 59]岁，其中6名（23%）为女性，评估时间为ECMO撤机后的中位数[IQR]22[17 - 23]个月。22名（85%）被诊断为新冠。WHODAS 2.0评分的中位数[IQR]为26[15 - 30]，在活动能力和参与领域的残疾程度最高。在24名全职工作的参与者中，12名（50%）能够以相同的能力工作。在基线时独立生活且接受调查的25名参与者中，22名（88%）在日常生活活动中保持完全独立（mRS＜3），1名（4%）表示存在持续的功能受限（mRS = 3），2名（8%）需要持续护理（mRS = 4或5）。分别有13名（52%）和9名（38%）报告至少有中度疼痛或焦虑。分别有10名（40%）和7名（28%）参与者筛查出抑郁或创伤后应激障碍症状呈阳性。
需要VV-ECMO的患者在出院后约两年经历了显著的功能残疾、疼痛、认知挑战、心理健康问题和较低的生活质量。
