Abstract：
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is increasingly used to support patients with severe acute respiratory distress syndrome (ARDS). The impact of ECMO on long-term outcomes of patients with severe ARDS is unclear.
METHODS: We searched electronic databases from inception to January 17th 2023. We selected clinical trials and observational studies reporting on long-term outcomes of patients supported with ECMO for ARDS. Health-related quality of life (HRQoL) was the primary outcome. Secondary outcomes included cognitive function, mental health, functional status, respiratory symptoms, and return to work.
RESULTS: Of the 7126 screened citations, 1 randomized clinical trial and 31 observational studies were included, of which 7 compared conventional mechanical ventilation (CMV) and ECMO. Overall quality of studies of the included studies was limited, with the majority being either low (45%) or fair (32%) quality. There was no significant difference in HRQoL measured with the SF-36 score between ECMO and CMV patients (physical component score [PCS]: mean difference 3.91 (- 6.22 to 14.05), mental component score [MCS] mean difference 1.33 (- 3.93 to 6.60)). There was no difference between cognitive function, mental health, functional status, and respiratory symptoms between ECMO and CMV, but data available for comparison were limited. There were high rates of disability for ECMO survivors with 49% of patients returning to work and 23% needing assistance at home on follow-up.
CONCLUSIONS: Survivors of ECMO for ARDS experience significant disability in multiple domains. Further studies are needed to examine the effect of ECMO on long-term outcomes of patients compared to CMV.
METHODS: We searched electronic databases from inception to January 17th 2023. We selected clinical trials and observational studies reporting on long-term outcomes of patients supported with ECMO for ARDS. Health-related quality of life (HRQoL) was the primary outcome. Secondary outcomes included cognitive function, mental health, functional status, respiratory symptoms, and return to work.
RESULTS: Of the 7126 screened citations, 1 randomized clinical trial and 31 observational studies were included, of which 7 compared conventional mechanical ventilation (CMV) and ECMO. Overall quality of studies of the included studies was limited, with the majority being either low (45%) or fair (32%) quality. There was no significant difference in HRQoL measured with the SF-36 score between ECMO and CMV patients (physical component score [PCS]: mean difference 3.91 (- 6.22 to 14.05), mental component score [MCS] mean difference 1.33 (- 3.93 to 6.60)). There was no difference between cognitive function, mental health, functional status, and respiratory symptoms between ECMO and CMV, but data available for comparison were limited. There were high rates of disability for ECMO survivors with 49% of patients returning to work and 23% needing assistance at home on follow-up.
CONCLUSIONS: Survivors of ECMO for ARDS experience significant disability in multiple domains. Further studies are needed to examine the effect of ECMO on long-term outcomes of patients compared to CMV.
摘要：
背景：体外膜氧合（ECMO）越来越多地用于支持严重急性呼吸窘迫综合征（ARDS）患者。ECMO对严重ARDS患者长期预后的影响尚不清楚。
方法：我们从成立到2023年1月17日检索了电子数据库。我们选择了临床试验和观察性研究，报告了ECMO支持的ARDS患者的长期结局。健康相关生活质量（HRQoL）是主要结果。次要结果包括认知功能，心理健康,功能状态，呼吸道症状,并返回工作。
结果：在7126份筛选的引文中，纳入1项随机临床试验和31项观察性研究，其中7个比较了常规机械通气(CMV)和ECMO。纳入研究的总体质量有限，大多数人要么质量低(45%)，要么质量一般(32%)。在ECMO和CMV患者之间，用SF-36评分测量的HRQoL没有显着差异（物理成分评分[PCS]：平均差3.91（-6.22至14.05），精神成分评分[MCS]平均差1.33(-3.93至6.60))。认知功能之间没有差异，心理健康,功能状态，ECMO和CMV之间的呼吸道症状，但可用于比较的数据有限.ECMO幸存者的致残率很高，其中49％的患者重返工作岗位，23％的患者需要在家中进行随访。
结论：ECMO治疗ARDS的幸存者在多个领域经历了显著的残疾。与CMV相比，需要进一步的研究来检查ECMO对患者长期预后的影响。
方法：我们从成立到2023年1月17日检索了电子数据库。我们选择了临床试验和观察性研究，报告了ECMO支持的ARDS患者的长期结局。健康相关生活质量（HRQoL）是主要结果。次要结果包括认知功能，心理健康,功能状态，呼吸道症状,并返回工作。
结果：在7126份筛选的引文中，纳入1项随机临床试验和31项观察性研究，其中7个比较了常规机械通气(CMV)和ECMO。纳入研究的总体质量有限，大多数人要么质量低(45%)，要么质量一般(32%)。在ECMO和CMV患者之间，用SF-36评分测量的HRQoL没有显着差异（物理成分评分[PCS]：平均差3.91（-6.22至14.05），精神成分评分[MCS]平均差1.33(-3.93至6.60))。认知功能之间没有差异，心理健康,功能状态，ECMO和CMV之间的呼吸道症状，但可用于比较的数据有限.ECMO幸存者的致残率很高，其中49％的患者重返工作岗位，23％的患者需要在家中进行随访。
结论：ECMO治疗ARDS的幸存者在多个领域经历了显著的残疾。与CMV相比，需要进一步的研究来检查ECMO对患者长期预后的影响。
