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Physical Function in Subjects Requiring Extracorporeal Membrane Oxygenation Before or After Lung Transplantation
journal contributionposted on 31.03.2021, 06:21 by Kathryn Hayes, Carol L Hodgson, Vincent A Pellegrino, Greg Snell, Benjamin Tarrant, Louise M Fuller, Anne Holland
© 2018 Daedalus Enterprises. BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy before and after lung transplantation, but little is known about functional recovery or complications after ECMO in this cohort. This study aimed to describe early physical function and leg complications in subjects who received ECMO before or after lung transplantation, and to compare functional outcomes to a matched cohort of subjects who did not require ECMO. METHODS: A retrospective study was conducted over 2 years. Highest mobility level was assessed, in both the ECMO and non-ECMO groups, prior to ICU admission, at ICU discharge, and at hospital discharge, while 6-min walk distance was measured at hospital discharge and at 3 months. Strength was assessed at ICU discharge and at hospital discharge in the ECMO subjects only, and leg complications were recorded up until hospital discharge. RESULTS: 17 subjects (mean age 43 ± 13 y; 65% (11 of 17 subjects) female) required ECMO before or after lung transplant. Survival to hospital discharge was 82% (14 of 17 subjects). At ICU discharge, strength and mobility levels were poor, but both improved by hospital discharge (P <.001). Leg complications were reported in 50% of survivors (7 of 14 subjects). ECMO survivors spent longer in the ICU (P <.001) and hospital (P =.002) and had worse physical function (ie, lower mobility level at ICU discharge, mean difference — 1, P =.02; 6-min walk distance at hospital discharge: mean difference — 99 m, P =.004) than lung transplant recipients not requiring ECMO (n = 28). CONCLUSIONS: In subjects requiring ECMO before or after lung transplantation, 82% survived to hospital discharge, but leg complications were common and physical function was poor at ICU discharge. Physical function improved over time, however subjects who required ECMO had a longer period of hospitalization and worse physical function at ICU and hospital discharge than those who did not require ECMO.
Pagination9p. (p. 194-202)
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Science & TechnologyLife Sciences & BiomedicineCritical Care MedicineRespiratory SystemGeneral & Internal Medicineextracorporeal membrane oxygenationlung transplantationrehabilitationquality of lifeINTENSIVE-CARE UNITACTIVE REHABILITATIONMUSCLE WEAKNESSBRIDGEDYSFUNCTIONSTRENGTHTHERAPYSOCIETYHEARTLIFELegHumansMusculoskeletal DiseasesLung DiseasesTreatment OutcomeWalkingPatient DischargeExtracorporeal Membrane OxygenationPostoperative PeriodLung TransplantationRetrospective StudiesRecovery of FunctionAdultMiddle AgedIntensive Care UnitsFemaleMalePreoperative PeriodWalk Test