Functional recovery in a cohort of ECMO and non-ECMO acute respiratory distress syndrome survivors.

Autor: Snyder M; University of Maryland School of Medicine, Baltimore, MD, USA., Njie BY; University of Maryland School of Medicine, Baltimore, MD, USA., Grabenstein I; University of Maryland School of Medicine, Baltimore, MD, USA., Viola S; Department of Medicine, Division of Critical Care Medicine, University of Maryland Baltimore Washington Medical Center, Baltimore, MD, USA., Abbas H; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA., Bhatti W; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA., Lee R; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA., Traficante R; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA., Yeung SYA; Department of Pharmacy Services, University of Maryland Medical Center, Baltimore, MD, USA., Chow JH; Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine, Washington, DC, USA., Tabatabai A; Department of Medicine, Division of Education, University of Maryland School of Medicine, Baltimore, MD, USA., Taylor BS; Division of Cardiothoracic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA., Dahi S; Division of Cardiothoracic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA., Scalea T; Department of Surgery and Program in Trauma, R Adams Crowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA., Rabin J; Department of Surgery and Program in Trauma, R Adams Crowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA., Grazioli A; Department of Medicine, University of Maryland School of Medicine, Program in Trauma, Baltimore, MD, USA., Calfee CS; Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, CA, USA., Britton N; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Levine AR; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA. Andrea.Levine@som.umaryland.edu.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2023 Nov 14; Vol. 27 (1), pp. 440. Date of Electronic Publication: 2023 Nov 14.
DOI: 10.1186/s13054-023-04724-y
Abstrakt: Background: The mortality benefit of VV-ECMO in ARDS has been extensively studied, but the impact on long-term functional outcomes of survivors is poorly defined. We aimed to assess the association between ECMO and functional outcomes in a contemporaneous cohort of survivors of ARDS.
Methods: Multicenter retrospective cohort study of ARDS survivors who presented to follow-up clinic. The primary outcome was FVC% predicted. Univariate and multivariate regression models were used to evaluate the impact of ECMO on the primary outcome.
Results: This study enrolled 110 survivors of ARDS, 34 of whom were managed using ECMO. The ECMO cohort was younger (35 [28, 50] vs. 51 [44, 61] years old, p < 0.01), less likely to have COVID-19 (58% vs. 96%, p < 0.01), more severely ill based on the Sequential Organ Failure Assessment (SOFA) score (7 [5, 9] vs. 4 [3, 6], p < 0.01), dynamic lung compliance (15 mL/cmH 2 0 [11, 20] vs. 27 mL/cmH 2 0 [23, 35], p < 0.01), oxygenation index (26 [22, 33] vs. 9 [6, 11], p < 0.01), and their need for rescue modes of ventilation. ECMO patients had significantly longer lengths of hospitalization (46 [27, 62] vs. 16 [12, 31] days, p < 0.01) ICU stay (29 [19, 43] vs. 10 [5, 17] days, p < 0.01), and duration of mechanical ventilation (24 [14, 42] vs. 10 [7, 17] days, p < 0.01). Functional outcomes were similar in ECMO and non-ECMO patients. ECMO did not predict changes in lung function when adjusting for age, SOFA, COVID-19 status, or length of hospitalization.
Conclusions: There were no significant differences in the FVC% predicted, or other markers of pulmonary, neurocognitive, or psychiatric functional recovery outcomes, when comparing a contemporaneous clinic-based cohort of survivors of ARDS managed with ECMO to those without ECMO.
(© 2023. The Author(s).)
Databáze: MEDLINE
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