Physical and Psychological Outcomes of Intensive Care Survivors Comparing Patients Who Received Venovenous Extracorporeal Membrane Oxygenation With Those Receiving Conventional Ventilation for a Minimum of 3 Days

Background<br/>Adult patients receiving extracorporeal membrane oxygenation (ECMO) for acute<br/>respiratory failure are generally younger with fewer comorbidities before ICU admission than other critically ill patients. These factors might be associated with less morbidity after hospital discharge. However, few studies compare patient-reported outcomes of ECMO survivors to those of the general ICU population.<br/><br/>Research question<br/>What are the psychological, health-related quality of life, sleep, swallowing, nutrition, airway, and voice outcomes measured three months after hospital discharge, comparing ICU survivors receiving ECMO to those receiving invasive mechanical ventilation (IMV) only?<br/><br/>Study design and methods<br/>Prospective observational longitudinal cohort (2015-2023) study recruiting patients attending a post-ICU recovery clinic. Data included demographic/clinical characteristics and self-reported outcomes. We compared outcomes using linear and logistic regression modelling.<br/><br/>Results<br/>We received patient-reported outcomes from 841/1848 (46%) post-ICU recovery clinic attendees. Of these, 289 (34%) received ECMO, were 13 years younger on average (P&lt;0.001), with more with white ethnicity (81% vs 61%, P =0.03). Compared to general ICU, ECMO patients had similar admission illness severity (median APACHE II score 16 in both), but a longer median (IQR) IMV duration (15 (10, 25) vs 8 (4, 16) days, P&lt;0.001) and higher delirium prevalence (75% versus 54%, P &lt;0.001).<br/>We found no difference in psychological morbidity prevalence and no association of ECMO with suspected PTSD (adjusted-odds ratio (aOR) 0.86, 95% confidence interval (CI) 0.59 to 1.24), controlling for age, sex and APACHE II score. Fewer ECMO patients had mobility issues (EQ-5D-5L mobility 29% vs 47%, P &lt;0.001). We found no differences in other physical morbidity outcomes and no association of ECMO on EQ5D VAS score (estimate 2.4, 95% CI -3.9 to 10.8).<br/><br/>Interpretation<br/>Except for better mobility, patients who received ECMO had similar outcomes after hospital discharge to patients requiring IMV only.