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Long-term functional and psychological recovery in a population of acute respiratory distress syndrome patients treated with VV-ECMO and in their caregivers
- Source :
- Minerva anestesiologica. 85(9)
- Publication Year :
- 2019
-
Abstract
- Background Acute respiratory distress syndrome (ARDS) survivors are affected with long-term physical/mental impairments, with improvements limited mostly to the first year after intensive care (ICU) discharge. Furthermore, caregivers of ICU patients exhibit psychological problems after family-member recovery. We evaluated the long-term physical and mental recovery of ARDS survivors treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO), and the long-term psychological impact on their caregivers. Methods Single-center prospective evaluation of a retrospective cohort of 75 ARDS patients treated with VV-ECMO during a seven-year period (25.10.2009-11.08.2016). Primary outcomes were the 36-Item Short-Form Health-Survey (SF-36, patients only), and risks of depression, anxiety or post-traumatic stress disorder (PTSD), both for patients and their caregivers. We investigated correlations between outcomes and population characteristics. Results Of 50 ICU-survivors, seven died later and five were not contactable. Among 38 living patients, 33 participated (87%, 31 with their caregiver) with 2.7 years of median follow-up. Physical and mental SF-36 component scores were 42 (inter-quartile range, IQR:22) and 52 (IQR:18.5), respectively. The worst domains of the SF-36 were physical-role limitations (25, IQR:100) and general-health perception (56, IQR:42.5). Psychological tests highlighted high risk of depression (39-42%, patients; 39-52%, caregivers), anxiety (42%, patients; 39%, caregivers), and PTSD (47%, patients; 61%, caregivers). Patient depression or anxiety scores were correlated to age and to the outcome reported by caregivers. Conclusions At almost three-year follow-up, ARDS survivors treated with VV-ECMO showed reduced health-related quality-of-life and high risk of psychological impairment, in particular PTSD. Caregivers of this population were at high psychological risk as well.
- Subjects :
- Adult
Male
ARDS
Pediatrics
medicine.medical_specialty
Population
Anxiety
Stress Disorders, Post-Traumatic
03 medical and health sciences
0302 clinical medicine
Extracorporeal Membrane Oxygenation
Tracheostomy
Quality of life
030202 anesthesiology
Intensive care
Medicine
Humans
Survivors
education
Depression (differential diagnoses)
Retrospective Studies
Patient health questionnaire
education.field_of_study
Psychological Tests
Respiratory Distress Syndrome
business.industry
Depression
030208 emergency & critical care medicine
Retrospective cohort study
Recovery of Function
Length of Stay
Middle Aged
medicine.disease
Patient Health Questionnaire
Critical care
Anesthesiology and Pain Medicine
Treatment Outcome
Caregivers
Quality of Life
Female
medicine.symptom
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 18271596
- Volume :
- 85
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Minerva anestesiologica
- Accession number :
- edsair.doi.dedup.....20942f179bb2f5435cd4e9388843fcd8