Long-Term Neuropsychiatric, Neurocognitive, and Functional Outcomes of Patients Receiving ECMO

BACKGROUND AND OBJECTIVES: Despite the common occurrence of neurologic complications during extracorporeal membrane oxygenation (ECMO) support, data on long-term neuropsychiatric, neurocognitive, and functional outcomes are sparse. We aimed to determine the prevalence of long-term neuropsychiatric s...

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Autores principales: Andrew Kalra, Jin Kook Kang, Shivalika Khanduja, Arjun K. Menta, Syed A. Ahmad, Olivia Liu, Emily Rodriguez, Marcus Spann, Adrían V. Hernández, Daniel Brodie, Glenn Whitman, Sung‐Min Cho
Formato: Otro
Lenguaje:inglés
Publicado: 2024
Materias:
Neurocognitive
Medicine
Anxiety
Depression (economics)
Cohort
Hospital Anxiety and Depression Scale
Neuropsychiatry
Psychiatry
Physical therapy
Pediatrics
Internal medicine
Cognition
Economics
Macroeconomics
Adult
Anxiety Disorders
Female
Humans
Male
Middle Aged
Pain
Sleep Wake Disorders
Extracorporeal Membrane Oxygenation adverse effects
Physical Sciences Engineering Biomedical Engineering Mechanical Circulatory Support Devices
Health Sciences Medicine Critical Care and Intensive Care Medicine Intensive Care Unit Cognitive Disorders
Health Sciences Medicine Pharmacology Antibiotics Pharmacokinetics and Efficacy
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Sumario:BACKGROUND AND OBJECTIVES: Despite the common occurrence of neurologic complications during extracorporeal membrane oxygenation (ECMO) support, data on long-term neuropsychiatric, neurocognitive, and functional outcomes are sparse. We aimed to determine the prevalence of long-term neuropsychiatric symptoms, neurocognitive and functional impairment, and favorable neurologic outcomes in adult patients who receive ECMO. METHODS: PubMed, Embase, Cochrane, Web of Science, and Scopus were searched for text related to ECMO and neuropsychiatric, neurocognitive, and functional outcomes from inception to May 3, 2023. Our primary outcome was the prevalence of neuropsychiatric symptoms (pain/discomfort, anxiety, depression, posttraumatic stress disorder [PTSD], and sleep disturbance) at long-term (≥6 months) follow-up. Our secondary outcomes were the prevalence of neurocognitive impairment (memory, attention, and reasoning), functional impairment (daily activities, physical activity/mobility, and personal/self-care), and favorable neurologic outcomes (Cerebral Performance Category ≤2, modified Rankin scale ≤3, or Glasgow Outcome Scale ≥4). This study was registered in PROSPERO (CRD42023420565). RESULTS: = 0.68). DISCUSSION: A substantial proportion of ECMO patients seemed to experience neuropsychiatric symptoms and neurocognitive and functional impairments at long-term follow-up. Considerable heterogeneity in methodology for gauging these outcomes exists, warranting the need for standardization. Multicenter prospective observational studies are indicated to further investigate risk factors for these outcomes in ECMO-supported patients.

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