Evaluating quality of life of extracorporeal membrane oxygenation survivors using the pediatric quality of life inventory survey

Purpose: This study assesses the impact of extracorporeal membrane oxygenation (ECMO) associated morbidities on long-term quality of life (QOL) outcomes. Methods: A single center, retrospective review of neonatal and pediatric non-cardiac ECMO survivors from 1/2005-7/2016 was performed. The 2012 Pediatric Quality of Life Inventory (TM) (PedsQL (TM)) survey was administered. Clinical outcomes and QOL scores between groups were compared. Results: Of 74 patients eligible, 64% (35 NICU, 12 PICU) completed the survey. Mean time since ECMO was 5.5 +/- 3 years. ECMO duration for venoarterial (VA) and venovenous (VV) were similar (median 9 vs. 7.5 days, p = 0.09). VA ECMO had higher overall complication rate (64% vs. 36%, p = 0.06) and higher neurologic complication rate (52% vs. 9%, p = 0.002). ECMO mode and ICU type did not impact QOL. However, patients with neurologic complications (n = 15) showed a trend towards lower overall QOL (63/100 +/- 20 vs. 74/100 +/- 18, p = 0.06) compared to patients without neurologic complications. A subset analysis of patients with ischemic or hemorrhagic intracranial injuries (n = 13) had significantly lower overall QOL (59/100 +/- 19 vs. 75/100 +/- 18, p = 0.01) compared to patients without intracranial injuries. Conclusion: Neurologic complication following ECMO is common, associated with VA mode, and negatively impacts long-term QOL. Given these associations, when clinically feasible, VV ECMO may be considered as first line ECMO therapy. (C) 2018 Elsevier Inc. All rights reserved.