Surviving Extracorporeal Membrane Oxygenation Is a Longitudinal Process: Exploring a Survivorship Model to Improve...

Venovenous extracorporeal membrane oxygenation is a salvage therapy for patients with acute respiratory distress syndrome. Survivors struggle with daily activities after decannulation and discharge. We evaluated outcomes after implementing a survivorship approach based on a cancer survivorship clinic model to improve quality of life (QoL) and optimize resource consumption.

We established a multidisciplinary survivorship clinic using telehealth and in-person physical and occupational therapy teams. Data from the 12-item Short Form Health Survey (SF-12) were collected between 2020 and 2023. Interviews were conducted at 6 months, 1 year, and 2 years after decannulation. The patients were offered in-person and telephone-based counseling with scheduled inpatient and outpatient rehabilitation visits. SF-12 mental component summary (MCS-12) and physical component summary (PCS-12) scores were used to calculate quality-adjusted life years (QALYs). The relationship between QoL, costs, and length of stay outcomes was assessed using generalized linear and mixed models.

Fifty-three patients were monitored for 3 years. Mean age was 41.7 years, 98.1% were White, and 50.9% were men. At 6 months, 1 year, and 2 years, mean MSC-12 scores were 52.9, 50, and 49.7, PCS-12 scores were 43.7, 41.8, and 47.3, and QALYs were 0.837, 0.829, and 0.826, respectively. MCS-12 showed no significant difference from the United States population. PCS-12 was significantly lower than the United States population during the first and second evaluations (P < .001) but showed no difference at 36 months. QALYs were significantly higher (P < .001). Higher resource consumption was associated with lower PCS-12 scores and QALYs.

The survivorship approach with counseling and rehabilitation yields acceptable QoL, which may inform strategies to improve the cost-effectiveness of venovenous extracorporeal membrane oxygenation.