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Langzeitfolgen bei ARDS-Patienten nach Lungenersatztherapie mit extrakorporaler Membranoxygenierung - Eine Pilotstudie zu Leistungsfähigkeit, Lebensqualität und Gesundheitszustand

by Marion Müller
Doctoral thesis
Date of Examination:2022-10-11
Date of issue:2022-10-11
Advisor:Dr. Lars-Olav Harnisch
Referee:Prof. Dr. Onnen Mörer
Referee:PD Dr. Aschraf El-Essawi
crossref-logoPersistent Address: http://dx.doi.org/10.53846/goediss-9475

 

 

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Abstract

English

Numerous follow-up studies exist regarding the acute respiratory distress syndrome (ARDS) as well as veno-venous extracorporeal membrane oxygenation (vvECMO), but a systematic follow-up of ADRS patients after ECMO therapy including physical and psychological examination, tests for quality of life, cognitive functions and post-traumatic stress disorder (PTSD) as well as an MRI-scan have not yet been described. In this prospective observational study 12 patients surviving ARDS after vv ECMO were examined. All 12 patients were able to lead a self-determined life and had been able to return to their former occupational field 5 - 32 months after ICU discharge (mean 16,5 months). The 36-Item Short Form Health Survey questionnaire (SF-36) showed a lower quality of life compared to the reference group in every category except general health (p = 0,857). The Impact of Events Scale-Revised (IES-R) questionnaire showed signs of PTSD in ten patients (83,3%). A modified Wechsler Memory Scale Test showed cognitive deficits compared to a healthy control group. The control group received better results in every category, four of seven sub categories showing significant results (logical memory I (p = 0,046) and II (p = 0,033), visual reproduction (p = 0,015) and spatial addition (p = 0,006)). Nerve impairments such as increased patella tendon reflex, impairments/lesion of N. cutaneus femoris lateralis on the cannulated extremity (50%) or paresis (14.3%) were found in the neurological examination. Ten patients received an MRI scan revealing cerebral hemorrhages, four patients (40%) showing microhemorrhages specifically in the splenium of the corpus callosum.
Keywords: ARDS; ECMO
 

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