Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 16;9(1):82.
doi: 10.1186/s13613-019-0556-1.

Long-term neurocognitive outcome is not worsened by of the use of venovenous ECMO in severe ARDS patients

Aude Sylvestre  1   2 , Mélanie Adda  1   2 , François Maltese  1   2 , Ariane Lannelongue  3 , Florence Daviet  1   2 , Gabriel Parzy  1   2 , Benjamin Coiffard  1   2 , Antoine Roch  2   4 , Anderson Loundou  5   6 , Karine Baumstarck  5   6 , Laurent Papazian  7   8
Affiliations

Long-term neurocognitive outcome is not worsened by of the use of venovenous ECMO in severe ARDS patients

Aude Sylvestre et al. Ann Intensive Care. .

Abstract

Background: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is associated with a significant morbidity. There is the need to investigate long-term cognitive outcome among ARDS survivors treated with VV-ECMO. We aimed to compare the prevalence of long-term cognitive dysfunction and neuropsychological impairment using a highly specific test in severe ARDS survivors treated or not treated with VV-ECMO.

Methods: Severe ARDS survivors treated between 2011 and 2017 in an ECMO Regional Referral Center were prospectively evaluated 2 years after their ICU discharge. Patients underwent an in-person interview and examination. The primary outcome was cognitive function, assessed by the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV). Secondary outcomes included anxiety, depression, post-traumatic stress disorder (PTSD) and quality-of-life.

Results: We investigated 40 consecutive patients surviving from severe ARDS treated (N = 22) or not (N = 18) with VV-ECMO at a median [interquartile range] of 20 [17-22] and 22 [18-23] months after ICU discharge, respectively. Regarding the main outcome, cognitive function was below normal ranges in 12 (55%) ECMO patients and 10 (56%) non-ECMO patients (p = 0.95). Eight (36%) ECMO patients had moderate-to-severe depressive symptoms as compared with 7 (39%) non-ECMO patients (p = 0.87). Twelve (55%) ECMO patients and eight (44%) non-ECMO patients had moderate-to-severe anxiety symptoms (p = 0.53). Seven (33%) ECMO patients and eight (44%) non-ECMO patients presented a PTSD (p = 0.48). Health-related quality of life did not differ between the two groups.

Conclusions: Using the WAIS-IV, VV-ECMO treatment does not appear to worsen long-term cognitive and neuropsychological outcomes in severe ARDS patients.

Keywords: Cognitive impairment; Long-term cognitive and psychiatric morbidity; Long-term neuropsychological outcome; PTSD; WAIS-IV.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart
Fig. 2
Fig. 2
Cognitive function assessed by the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Papazian L, Aubron C, Brochard L, et al. Formal guidelines: management of acute respiratory distress syndrome. Ann Intensive Care. 2019;9:69. doi: 10.1186/s13613-019-0540-9. - DOI - PMC - PubMed
    1. Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315:788–800. doi: 10.1001/jama.2016.0291. - DOI - PubMed
    1. Roch A, Hraiech S, Masson E, et al. Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center. Intensive Care Med. 2014;40:74–83. doi: 10.1007/s00134-013-3135-1. - DOI - PMC - PubMed
    1. Extracorporeal Life Support Organization. Registry report: international summary January 2019. https://www.elso.org. Accessed 14 July 2019.
    1. Peek GJ, Mugford M, Tiruvoipati R, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. The Lancet. 2009;374:1351–1363. doi: 10.1016/S0140-6736(09)61069-2. - DOI - PubMed

LinkOut - more resources