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Critical Care
Published in: Critical Care 5/2012

Open Access 01-10-2012 | Research

Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia

Authors: Carol L Hodgson, Kate Hayes, Tori Everard, Alistair Nichol, Andrew R Davies, Michael J Bailey, David V Tuxen, David J Cooper, Vin Pellegrino

Published in: Critical Care | Issue 5/2012

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Abstract

Introduction

The purpose of the study was to assess the long term outcome and quality of life of patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) for refractory hypoxemia.

Methods

A retrospective observational study with prospective health related quality of life (HRQoL) assessment was conducted in ARDS patients who had ECMO as a rescue therapy for reversible refractory hypoxemia from January 2009 until April 2011 in a tertiary Australian centre. Survival and long-term quality of life assessment, using the Short-Form 36 (SF-36) and the EuroQol health related quality of life questionnaire (EQ5D) were assessed and compared to international data from other research groups.

Results

Twenty-one patients (mean age 36.3 years) with ARDS receiving ECMO for refractory hypoxemia were studied. Eighteen (86%) patients were retrieved from external intensive care units (ICUs) by a dedicated ECMO retrieval team. Eleven (55%) had H1N1 influenza A-associated pneumonitis. Eighteen (86%) patients survived to hospital discharge. Of the 18 survivors, ten (56%) were discharged to other hospitals and 8 (44%) were discharged directly home. Sequelae and health related quality of life were evaluated for 15 of the 18 (71%) long-term survivors (assessment at median 8 months). Mean SF-36 scores were significantly lower across all domains compared to age and sex matched Australian norms. Mean SF-36 scores were lower (minimum important difference at least 5 points) than previously described ARDS survivors in the domains of general health, mental health, vitality and social function. One patient had long-term disability as a result of ICU acquired weakness. Only 26% of survivors had returned to previous work levels at the time of follow-up.

Conclusions

This ARDS cohort had a high survival rate (86%) after use of ECMO support for reversible refractory hypoxemia. Long term survivors had similar physical health but decreased mental health, general health, vitality and social function compared to other ARDS survivors and an unexpectedly poor return to work.
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Literature
1.
Davydow DS, Desai SV, Needham DM, Bienvenu OJ: Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med 2008, 70: 512-519. 10.1097/PSY.0b013e31816aa0ddCrossRefPubMed
2.
Dowdy DW, Eid MP, Dennison CR, Mendez-Tellez PA, Herridge MS, Guallar E, Pronovost PJ, Needham DM: Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med 2006, 32: 1115-1124. 10.1007/s00134-006-0217-3CrossRefPubMed
3.
Hough CL, Herridge MS: Long-term outcome after acute lung injury. Curr Opin Crit Care 2012, 18: 8-15. 10.1097/MCC.0b013e32834f186dCrossRefPubMed
4.
Mikkelsen ME, Christie JD, Lanken PN, Biester RC, Thompson BT, Bellamy SL, Localio AR, Demissie E, Hopkins RO, Angus DC: The ARDS Cognitive Outcomes Study (ACOS): Long-Term Neuropsychological Function in Acute Lung Injury Survivors. Am J Respir Crit Care Med 2012.
5.
Herridge MS, Tansey CM, Matte A, Tomlinson G, Diaz-Granados N, Cooper A, Guest CB, Mazer CD, Mehta S, Stewart TE, Kudlow P, Cook D, Slutsky AS, Cheung AM: Functional disability 5 years after acute respiratory distress syndrome. New Engl J Med 2011, 364: 1293-1304. 10.1056/NEJMoa1011802CrossRefPubMed
6.
Bersten AD, Edibam C, Hunt T, Moran J: Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian States. Am J Respir Crit Care Med 2002, 165: 443-448.CrossRefPubMed
7.
Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, Davies AR, Hand LE, Zhou Q, Thabane L, Austin P, Lapinsky S, Baxter A, Russell J, Skrobik Y, Ronco JJ, Stewart TE: Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 2008, 299: 637-645. 10.1001/jama.299.6.637CrossRefPubMed
8.
Mercat A, Richard JC, Vielle B, Jaber S, Osman D, Diehl JL, Lefrant JY, Prat G, Richecoeur J, Nieszkowska A, Gervais C, Baudot J, Bouadma L, Brochard L: Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 2008, 299: 646-655. 10.1001/jama.299.6.646CrossRefPubMed
9.
Combes A, Bacchetta M, Brodie D, Muller T, Pellegrino V: Extracorporeal membrane oxygenation for respiratory failure in adults. Curr Opin Crit Care 2012, 18: 99-104. 10.1097/MCC.0b013e32834ef412CrossRefPubMed
10.
Liu LL, Aldrich JM, Shimabukuro DW, Sullivan KR, Taylor JM, Thornton KC, Gropper MA: Special article: rescue therapies for acute hypoxemic respiratory failure. Anesth Analg 2010, 111: 693-702. 10.1213/ANE.0b013e3181e9c356CrossRefPubMed
11.
Walkey AJ, Wiener RS: Utilization patterns and patient outcomes associated with use of rescue therapies in acute lung injury. Crit Care Med 2011, 39: 1322-1328. 10.1097/CCM.0b013e3182120829PubMedCentralCrossRefPubMed
12.
Kolla S, Awad SS, Rich PB, Schreiner RJ, Hirschl RB, Bartlett RH: Extracorporeal life support for 100 adult patients with severe respiratory failure. Ann Surg 1997, 226: 544-564. discussion 565-546 10.1097/00000658-199710000-00015PubMedCentralCrossRefPubMed
13.
Linden V, Palmer K, Reinhard J, Westman R, Ehren H, Granholm T, Frenckner B: High survival in adult patients with acute respiratory distress syndrome treated by extracorporeal membrane oxygenation, minimal sedation, and pressure supported ventilation. Intensive Care Med 2000, 26: 1630-1637. 10.1007/s001340000697CrossRefPubMed
14.
Peek GJ, Elbourne D, Mugford M, Tiruvoipati R, Wilson A, Allen E, Clemens F, Firmin R, Hardy P, Hibbert C, Jones N, Killer H, Thalanany M, Truesdale A: Randomised controlled trial and parallel economic evaluation of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR). Health Technol Asses 2010, 14: 1-46.CrossRef
15.
Linden VB, Lidegran MK, Frisen G, Dahlgren P, Frenckner BP, Larsen F: ECMO in ARDS: a long-term follow-up study regarding pulmonary morphology and function and health-related quality of life. Acta Anaesth Scand 2009, 53: 489-495. 10.1111/j.1399-6576.2008.01808.xCrossRefPubMed
16.
Schelling G, Stoll C, Vogelmeier C, Hummel T, Behr J, Kapfhammer HP, Rothenhausler HB, Haller M, Durst K, Krauseneck T, Briegel J: Pulmonary function and health-related quality of life in a sample of long-term survivors of the acute respiratory distress syndrome. Intensive Care Med 2000, 26: 1304-1311. 10.1007/s001340051342CrossRefPubMed
17.
Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, Hibbert CL, Truesdale A, Clemens F, Cooper N, Firmin RK, Elbourne D, Collaboration CT: Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009, 374: 1351-1363. 10.1016/S0140-6736(09)61069-2CrossRefPubMed
18.
Luyt CE, Combes A, Becquemin MH, Beigelman-Aubry C, Hatem S, Brun AL, Zraik N, Carrat F, Grenier PA, Richard JC, Mercat A, Brochard L, Brun-Buisson C, Chastre J: Long-term outcomes of pandemic 2009 influenza A (H1N1)-associated severe acute respiratory distress syndrome. Chest 2012.
19.
Davies A, Jones D, Bailey M, Beca J, Bellomo R, Blackwell N, Forrest P, Gattas D, Granger E, Herkes R, Jackson A, McGuinness S, Nair P, Pellegrino V, Pettila V, Plunkett B, Pye R, Torzillo P, Webb S, Wilson M, Ziegenfuss M: Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA 2009, 302: 1888-1895.CrossRefPubMed
20.
Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S, Stewart TE, Barr A, Cook D, Slutsky AS: One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003, 348: 683-693. 10.1056/NEJMoa022450CrossRefPubMed
21.
Higgins AM, Pettila V, Harris AH, Bailey M, Lipman J, Seppelt IM, Webb SA: The critical care costs of the influenza A/H1N1 2009 pandemic in Australia and New Zealand. Anaesth Intens Care 2011, 39: 384-391.
22.
Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R: The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994, 149: 818-824.CrossRefPubMed
23.
Rich PB, Awad SS, Crotti S, Hirschl RB, Bartlett RH, Schreiner RJ: A prospective comparison of atrio-femoral and femoro-atrial flow in adult venovenous extracorporeal life support. J Thorac Cardiovasc Surg 1998, 116: 628-632. 10.1016/S0022-5223(98)70170-9CrossRefPubMed
24.
EuroQol--a new facility for the measurement of health-related quality of life. The EuroQol Group Health Policy 1990, 16: 199-208.
25.
Hawthorne G, Osborne RH, Taylor A, Sansoni J: The SF36 Version 2: critical analyses of population weights, scoring algorithms and population norms. Qual Life Res 2007, 16: 661-673. 10.1007/s11136-006-9154-4CrossRefPubMed
26.
Ware JE, Kosinski M, Keller S: Physical and Mental Health Summary Scales: A User's Manual. Boston, MA: The Health Institute, New England Medical Centre; 1994.
27.
National Health Survey: SF-36 Population Norms, Australia. Canberra 1995. Australian Bureau of Statistics; 1997.
28.
Dowdy DW, Eid MP, Dennison CR, Mendez-Tellez PA, Herridge MS, Guallar E, Pronovost PJ, Needham DM: Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med 2006, 32: 1115-1124. 10.1007/s00134-006-0217-3CrossRefPubMed
29.
Skinner EH, Warrillow S, Denehy L: Health-related quality of life in Australian survivors of critical illness. Crit Care Med 2011, 39: 1896-1905. 10.1097/CCM.0b013e31821b8421CrossRefPubMed
30.
Forrest P, Ratchford J, Burns B, Herkes R, Jackson A, Plunkett B, Torzillo P, Nair P, Granger E, Wilson M, Pye R: Retrieval of critically ill adults using extracorporeal membrane oxygenation: an Australian experience. Intensive Care Med 2011, 37: 824-830. 10.1007/s00134-011-2158-8CrossRefPubMed
31.
Herridge MS, Tansey CM, Matte A, Tomlinson G, Diaz-Granados N, Cooper A, Guest CB, Mazer CD, Mehta S, Stewart TE, Kudlow P, Cook D, Slutsky AS, Cheung AM, Grp CCCT: Functional Disability 5 Years after Acute Respiratory Distress Syndrome. New Engl J Med 2011, 364: 1293-1304. 10.1056/NEJMoa1011802CrossRefPubMed
32.
Wilcox ME, Herridge MS: Long-term outcomes in patients surviving acute respiratory distress syndrome. Semin Respir Crit Care Med 2010, 31: 55-65. 10.1055/s-0029-1246285CrossRefPubMed
33.
Orme J, Romney JS, Hopkins RO, Pope D, Chan KJ, Thomsen G, Crapo RO, Weaver LK: Pulmonary function and health-related quality of life in survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 2003, 167: 690-694. 10.1164/rccm.200206-542OCCrossRefPubMed
34.
Adhikari NK, McAndrews MP, Tansey CM, Matte A, Pinto R, Cheung AM, Diaz-Granados N, Barr A, Herridge MS: Self-reported symptoms of depression and memory dysfunction in survivors of ARDS. Chest 2009, 135: 678-687. 10.1378/chest.08-0974CrossRefPubMed
35.
Angus DC, Musthafa AA, Clermont G, Griffin MF, Linde-Zwirble WT, Dremsizov TT, Pinsky MR: Quality-adjusted survival in the first year after the acute respiratory distress syndrome. Am J Respir Crit Care Med 2001, 163: 1389-1394.CrossRefPubMed
36.
Noah MA, Peek GJ, Finney SJ, Griffiths MJ, Harrison DA, Grieve R, Sadique MZ, Sekhon JS, McAuley DF, Firmin RK, Harvey C, Cordingley JJ, Price S, Vuylsteke A, Jenkins DP, Noble DW, Bloomfield R, Walsh TS, Perkins GD, Menon D, Taylor BL, Rowan KM: Referral to an extracorporeal membrane oxygenation maneuvers and mortality among patients with severe 2009 influenza A(H1N1). JAMA 2011, 306: 1659-1668. 10.1001/jama.2011.1471CrossRefPubMed
37.
38.
Burtin C, Clerckx B, Robbeets C, Ferdinande P, Langer D, Troosters T, Hermans G, Decramer M, Gosselink R: Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med 2009, 37: 2499-2505. 10.1097/CCM.0b013e3181a38937CrossRefPubMed
39.
Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, Spears L, Miller M, Franczyk M, Deprizio D, Schmidt GA, Bowman A, Barr R, McCallister KE, Hall JB, Kress JP: Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 2009, 373: 1874-1882. 10.1016/S0140-6736(09)60658-9CrossRefPubMed
40.
Perkins JJ, Sanson-Fisher RW: An examination of self- and telephone-administered modes of administration for the Australian SF-36. J Clin Epidemiol 1998, 51: 969-973. 10.1016/S0895-4356(98)00088-2CrossRefPubMed
41.
Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, D'Urso P, Kossmann T, Ponsford J, Seppelt I, Reilly P, Wolfe R: Decompressive craniectomy in diffuse traumatic brain injury. New Engl J Med 2011, 364: 1493-1502. 10.1056/NEJMoa1102077CrossRefPubMed
Metadata
Title
Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia
Authors
Carol L Hodgson
Kate Hayes
Tori Everard
Alistair Nichol
Andrew R Davies
Michael J Bailey
David V Tuxen
David J Cooper
Vin Pellegrino
Publication date
01-10-2012
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2012
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11811

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