Post-discharge health-related quality of life, cognitive function, disability, risk of post-traumatic stress disorder, and depression amongst the survivors of venovenous extracorporeal membrane oxygenation (VV-ECMO) during the COVID-19 pandemic: a nested cohort study protocol

Eunicia Ursu, Ana Mikolic, Sonny Thiara, Noah D Silverberg, Denise Foster, William Panenka, Nishtha Parag, Mypinder S Sekhon, Donald E.G. Griesdale
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Abstract

Background Veno-venous extra-corporeal membrane oxygenation (VV ECMO) is a form of mechanical respiratory support for critically ill patients with severe acute respiratory distress syndrome (ARDS). Using a large intravenous line in a closed circuit, blood is removed from the patient and passed through a hollow fiber membrane where oxygen is added and carbon dioxide is removed. The oxygenated blood is then reinfused into the patient. Overt neurologic injury (ischemic stroke or intracerebral hemorrhage) occurs in approximately 20% of patients who receive VV ECMO. However, it is unclear if there is additional unrecognized neurologic disability amongst patients who survive VV ECMO. As such, we will perform a cohort study nested within our existing prospective study of patients who underwent VV ECMO during the COVID 19 pandemic. We expect to ascertain long-term patient reported and performance-based outcomes in greater than 60% of survivors of VV-ECMO. This study will provide important patient-centric long-term outcomes in contrast to the majority of existing studies of patients on VV-ECMO which focus solely on short-term survival. Methods and analysis We will include 39 patients who survived VV-ECMO and ascertain patient reported and performance-based outcomes through phone interviews. We will measure: i) Health Related Quality of Life (HRQoL) using the EQ 5D 5L, ii) cognitive function using the T-MoCA Short, iii) disability using the World Health Organization Disability Assessment Scale (WHODAS) 2.0, iv) post traumatic stress disorder (PTSD) using the Impact of Event Scale 6 (IES 6), and v) depression using the Patient Health Questionnaire 9 (PHQ-9). Ethics and dissemination The results from the analysis of the study data will be disseminated through presentation of a scientific abstract at international conference, and submission of a manuscript in a peer-reviewed critical care medicine journal. The study ethical approval has been obtained from the University of British Columbia (UBC) Clinical Research Ethics Board (REB)(H21 00033) and the Vancouver Coastal Health Research Institute (V21 00033).
COVID-19 大流行期间静脉体外膜氧合(VV-ECMO)幸存者出院后与健康相关的生活质量、认知功能、残疾、创伤后应激障碍风险和抑郁症:巢式队列研究方案
背景 静脉-静脉体外膜肺氧合(VV ECMO)是一种用于严重急性呼吸窘迫综合征(ARDS)重症患者的机械呼吸支持方式。通过闭合回路中的大型静脉管路,从患者体内抽取血液并通过中空纤维膜,在膜中加入氧气并排出二氧化碳。然后将含氧血液重新注入患者体内。接受 VV ECMO 的患者中约有 20% 会出现明显的神经损伤(缺血性中风或脑内出血)。然而,目前还不清楚在 VV ECMO 存活的患者中是否存在其他未被发现的神经系统残疾。因此,我们将在现有的前瞻性研究中对在 COVID 19 大流行期间接受 VV ECMO 的患者进行队列研究。我们希望能确定超过 60% 的 VV-ECMO 幸存者的长期患者报告和基于表现的结果。这项研究将提供以患者为中心的重要长期结果,而现有的大多数 VV-ECMO 患者研究仅关注短期存活率。方法与分析 我们将纳入 39 名 VV-ECMO 存活患者,并通过电话访谈确定患者报告的结果和基于表现的结果。我们将测量:i) 使用 EQ 5D 5L 测量与健康相关的生活质量 (HRQoL);ii) 使用 T-MoCA Short 测量认知功能;iii) 使用世界卫生组织残疾评估量表 (WHODAS) 2.0 测量残疾;iv) 使用事件影响量表 6 (IES 6) 测量创伤后应激障碍 (PTSD);v) 使用患者健康问卷 9 (PHQ-9) 测量抑郁。伦理与传播 研究数据分析结果将通过在国际会议上提交科学摘要和在同行评审的重症医学杂志上投稿的方式进行传播。该研究已获得不列颠哥伦比亚大学(UBC)临床研究伦理委员会(REB)(H21 00033)和温哥华海岸健康研究所(V21 00033)的伦理批准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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