Physical Function in Subjects Requiring Extracorporeal Membrane Oxygenation Before or After Lung Transplantation

Autor: Anne E Holland, Gregory I Snell, Vincent Pellegrino, Benjamin J. Tarrant, L.M. Fuller, Kate Hayes, Carol L. Hodgson
Rok vydání: 2017
Předmět:
Adult
Lung Diseases
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.medical_treatment
Walk Test
Walking
030204 cardiovascular system & hematology
Physical function
Critical Care and Intensive Care Medicine
03 medical and health sciences
Extracorporeal Membrane Oxygenation
0302 clinical medicine
Quality of life
Extracorporeal membrane oxygenation
Humans
Medicine
Lung transplantation
Musculoskeletal Diseases
Postoperative Period
Retrospective Studies
Leg
Rehabilitation
Lung
business.industry
Retrospective cohort study
Recovery of Function
General Medicine
Middle Aged
Patient Discharge
Surgery
Intensive Care Units
Treatment Outcome
surgical procedures
operative
medicine.anatomical_structure
030228 respiratory system
Anesthesia
Preoperative Period
Cohort
Female
business
Lung Transplantation
Zdroj: Respiratory Care. 63:194-202
ISSN: 1943-3654
0020-1324
DOI: 10.4187/respcare.05334
Popis: BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy before and after lung transplantation, but little is known about functional recovery or complications after ECMO in this cohort. This study aimed to describe early physical function and leg complications in subjects who received ECMO before or after lung transplantation, and to compare functional outcomes to a matched cohort of subjects who did not require ECMO. METHODS: A retrospective study was conducted over 2 years. Highest mobility level was assessed, in both the ECMO and non-ECMO groups, prior to ICU admission, at ICU discharge, and at hospital discharge, while 6-min walk distance was measured at hospital discharge and at 3 months. Strength was assessed at ICU discharge and at hospital discharge in the ECMO subjects only, and leg complications were recorded up until hospital discharge. RESULTS: 17 subjects (mean age 43 ± 13 y; 65% (11 of 17 subjects) female) required ECMO before or after lung transplant. Survival to hospital discharge was 82% (14 of 17 subjects). At ICU discharge, strength and mobility levels were poor, but both improved by hospital discharge ( P P P = .002) and had worse physical function (ie, lower mobility level at ICU discharge, mean difference −1, P = .02; 6-min walk distance at hospital discharge: mean difference −99 m, P = .004) than lung transplant recipients not requiring ECMO ( n = 28). CONCLUSIONS: In subjects requiring ECMO before or after lung transplantation, 82% survived to hospital discharge, but leg complications were common and physical function was poor at ICU discharge. Physical function improved over time, however subjects who required ECMO had a longer period of hospitalization and worse physical function at ICU and hospital discharge than those who did not require ECMO.
Databáze: OpenAIRE
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