Physical Function in Subjects Requiring Extracorporeal Membrane Oxygenation Before or After Lung Transplantation.

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy before and after lung transplantation, but little is known about functional recovery or complications after ECMO in this cohort. This study aimed to describe early physical function and leg complications in subjects w...

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Publicado en:Respiratory Care Vol. 63; no. 2; pp. 194 - 203
Autores principales: Hayes, Kate, Hodgson, Carol L., Pellegrino, Vincent A., Snell, Greg, Tarrant, Benjamin, Fuller, Louise M., Holland, Anne E.
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Feb2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2018
      vid: 63
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.4187/respcare.05334
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        atl: Physical Function in Subjects Requiring Extracorporeal Membrane Oxygenation Before or After Lung Transplantation.
      aug:
        au:
          Hayes, Kate
          Hodgson, Carol L.
          Pellegrino, Vincent A.
          Snell, Greg
          Tarrant, Benjamin
          Fuller, Louise M.
          Holland, Anne E.
        affil: Department of Physiotherapy, The Alfred Hospital, Melbourne, Victoria, Australia
      sug:
        subj:
          Extracorporeal Membrane Oxygenation
          Lung Transplantation
          Human
          Retrospective Design
          Adult
          Middle Age
          Male
          Female
          Rehabilitation
          Quality of Life
          Time Factors
          Data Analysis Software
          Paired T-Tests
          Mann-Whitney U Test
          Chi Square Test
          Fisher's Exact Test
          Wilcoxon Rank Sum Test
          Nonparametric Statistics
          Multiple Linear Regression
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy before and after lung transplantation, but little is known about functional recovery or complications after ECMO in this cohort. This study aimed to describe early physical function and leg complications in subjects who received ECMO before or after lung transplantation, and to compare functional outcomes to a matched cohort of subjects who did not require ECMO. METHODS: A retrospective study was conducted over 2 years. Highest mobility level was assessed, in both the ECMO and non-ECMO groups, prior to ICU admission, at ICU discharge, and at hospital discharge, while 6-min walk distance was measured at hospital discharge and at 3 months. Strength was assessed at ICU discharge and at hospital discharge in the ECMO subjects only, and leg complications were recorded up until hospital discharge. RESULTS: 17 subjects (mean age 43±13 y; 65% (11 of 17 subjects) female) required ECMO before or after lung transplant. Survival to hospital discharge was 82% (14 of 17 subjects). At ICU discharge, strength and mobility levels were poor, but both improved by hospital discharge (P < .001). Leg complications were reported in 50% of survivors (7 of 14 subjects). ECMO survivors spent longer in the ICU (P < .001) and hospital (P = .002) and had worse physical function (ie, lower mobility level at ICU discharge, mean difference -1, P = .02; 6-min walk distance at hospital discharge: mean difference -99 m, P = .004) than lung transplant recipients not requiring ECMO (n = 28). CONCLUSIONS: In subjects requiring ECMO before or after lung transplantation, 82% survived to hospital discharge, but leg complications were common and physical function was poor at ICU discharge. Physical function improved over time, however subjects who required ECMO had a longer period of hospitalization and worse physical function at ICU and hospital discharge than those who did not require ECMO.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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