Palliative Care Utilization in Patients Requiring Extracorporeal Membrane Oxygenation: An Observational Study.

Area of Science:

• Critical Care Medicine
• Palliative Care
• Health Services Research

Background:

• Palliative care (PC) improves quality of life for patients with life-limiting illnesses.
• Few studies have explored PC's impact on patients requiring extracorporeal membrane oxygenation (ECMO).
• Understanding PC consultation patterns in ECMO patients is crucial for optimizing care.

Purpose of the Study:

• To describe demographics, clinical characteristics, and complications of PC consultation in adult ECMO patients.
• To identify factors associated with receiving PC consultation during ECMO support.
• To assess the utilization and characteristics of PC consultations in this complex patient population.

Main Methods:

• Retrospective analysis of an ECMO registry (July 2016 - September 2021).
• Inclusion of adult patients (≥18 years) receiving venoarterial (VA)-ECMO or venovenous (VV)-ECMO.
• Statistical analysis using ANOVA and Fisher exact tests to determine factors associated with PC consultation.

Main Results:

• 44.9% of ECMO patients received PC consultation.
• PC consultation was linked to non-white race, medical vs. surgical specialty, VV-ECMO, and longer ECMO duration.
• Patients who died had significantly more PC visits (11.2 vs. 5.6).

Conclusions:

• Palliative care is underutilized in ECMO patients despite its benefits.
• Factors such as race, ECMO type, and duration influence PC consultation rates.
• Further research and interventions are needed to enhance PC access for ECMO patients.