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Observational Study
. 2025 Dec 1;53(12):e2487-e2496.
doi: 10.1097/CCM.0000000000006900. Epub 2025 Oct 15.

Five Years After Extracorporeal Membrane Oxygenation: A Prospective Cohort Study of Health-Related Quality of Life and Patient Outcomes

Floris E J Jolink  1   2 , Marisa Onrust  1 , Dinis Dos Reis Miranda  3 , Loes Mandigers  4   5 , Thijs Delnoij  6 , Jacinta J Maas  7 , S Jorinde Raasveld  8   9 , Alexander P J Vlaar  8 , Dirk W Donker  10   11 , Erik Scholten  12 , Jesse de Metz  13 , Judith van den Brule  14 , Marijn Kuijpers  15 , Karin M Vermeulen  16 , Peter H J van der Voort  17 , Walter M van den Bergh  1 , Annemieke Oude Lansink-Hartgring  1 ; Dutch Extracorporeal Life Support (ECLS) Study Group
Collaborators, Affiliations
Observational Study

Five Years After Extracorporeal Membrane Oxygenation: A Prospective Cohort Study of Health-Related Quality of Life and Patient Outcomes

Floris E J Jolink et al. Crit Care Med. .

Abstract

Objectives: To report on 5-year survival, health-related quality of life (HRQoL), and occupational status of patients with respiratory or cardiac failure, who were supported with extracorporeal membrane oxygenation (ECMO).

Design: A prospective multicenter observational cohort follow-up study.

Setting: ICUs of ten ECMO centers in the Netherlands, representing more than 90% of all patients supported with ECMO in the Netherlands.

Patients: Patients supported with ECMO between August 2017 and July 2019.

Interventions: None.

Measurements and main results: Survival was assessed by consulting the Dutch municipal records database. All 5-year survivors received a questionnaire. HRQoL was assessed using the standardized EuroQol 5D Five Levels instrument, and occupational status was assessed using the standardized Institute for Medical Technology Assessment Productivity Cost Questionnaire. Of the initial 428 participants, 230 (54%) survived the hospital admission, 213 (50%) survived the first year, and 155 (36%) survived 5 years. Five-year survival rates were 42% for patients receiving ECMO for respiratory support, 39% for cardiac support, and 25% for extracorporeal cardiopulmonary resuscitation. The response rate to the questionnaire was 72%. HRQoL was rated satisfactory at 5 years, with a median EuroQol index of 0.82 (interquartile range, 0.73-0.98). Five-year survivors reported slight-to-moderate impairment of mobility (39%), impairment of usual activities (44%), and pain or discomfort (60%). After 5 years, the majority of patients were either employed (41%), retired (31%), or permanently declared unfit for work (26%).

Conclusions: Long-term outcome in patients supported with ECMO is good. Five-year survivors reported that HRQoL was satisfactory despite some impairment in day-to-day functioning.

Trial registration: ClinicalTrials.gov NCT02837419.

Keywords: critical care; extracorporeal membrane oxygenation; follow-up studies; quality of life; return to work; survival.

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Conflict of interest statement

Dr. Jolink’s institution received funding from the Netherlands Organization for Health Research and Development (ZonMw); he received support for article research from ZonMw (84300280). Dr. Miranda received funding from Resuscitec and Getting. Dr. Donker’s institution received funding from Maquet Critical Care AB, Abiomed, and Sonion BV. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart of the studied population. This flowchart illustrates patients included for follow-up 5 yr after initiation of extracorporeal membrane oxygenation. It details the number of survivors and respondents to the health-related quality of life and occupational status questionnaires, while also indicating the number of patients lost to follow-up due to an unknown address and those who did not respond. CEES = Cost-Effectiveness of Extracorporeal Membrane Oxygenation Study.
Figure 2.
Figure 2.
Kaplan-Meier survival curves. This Kaplan-Meier curve illustrates survival probabilities for patients supported with different extracorporeal membrane oxygenation (ECMO) modes. Survival is highlighted at 6 mo, 1 yr, and 5 yr for respiratory ECMO (blue), cardiac ECMO (orange), and extracorporeal cardiopulmonary resuscitation (ECPR; green).
Figure 3.
Figure 3.
Percentage of participants reporting some degree (slight to extreme) of problems on the various EuroQol 5D domains. This bar chart illustrates the percentage of patients reporting some degree of problems across different EuroQol 5D Five Levels domains. The bar length is based on the absolute number of respondents reporting a problem in the domain, divided by the total number of respondents for that domain. Responses from 1-yr survivors (blue) and 5-yr survivors (green) are compared with a reference population (orange) from a Belgian cohort, representing the frequency of reported problems in healthy individuals of any age. For each domain, the remaining percentage reflects those who reported no issues. *Data of a Belgian reference population, as reported by van Wilder et al (12).
See this image and copyright information in PMC

References

    1. Tonna JE, Boonstra PS, MacLaren G, et al. ; Extracorporeal Life Support Organization (ELSO) Member Centers Group: Extracorporeal life support organization registry international report 2022: 100,000 Survivors. ASAIO J. 2024; 70:131–143 - PMC - PubMed
    1. Oude Lansink-Hartgring A, Miranda DDR, Mandigers L, et al. ; Dutch ECLS Study group: Health-related quality of life, one-year costs and economic evaluation in extracorporeal membrane oxygenation in critically ill adults. J Crit Care. 2023; 73:154215. - PubMed
    1. Yannopoulos D, Bartos J, Raveendran G, et al. : Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): A phase 2, single centre, open-label, randomised controlled trial. Lancet. 2020; 396:1807–1816 - PMC - PubMed
    1. Belohlavek J, Kucera K, Jarkovsky J, et al. : Hyperinvasive approach to out-of hospital cardiac arrest using mechanical chest compression device, prehospital intraarrest cooling, extracorporeal life support and early invasive assessment compared to standard of care. A randomized parallel groups comparative study proposal. “Prague OHCA study”. J Transl Med. 2012; 10:163. - PMC - PubMed
    1. Combes A, Hajage D, Capellier G, et al. ; EOLIA Trial Group, REVA, and ECMONet: Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med. 2018; 378:1965–1975 - PubMed

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