(1789) Long-Term Cognitive and Functional Outcomes After Venovenous Extracorporeal Membrane Oxygenation

Introduction: Use of venovenous extracorporeal membrane oxygenation (V-V ECMO) to support patients with severe respiratory failure is rapidly expanding. While short-term outcomes of V-V ECMO are well-documented, long-term neurocognitive, functional, and quality of life outcomes remain underexplored. This study aims to assess long-term cognitive, functional, and quality of life outcomes in survivors of V-V ECMO.

Methods: We conducted a retrospective analysis of patients in the Cognitive Outcomes in PILOT (CO-PILOT) study who received V-V ECMO between July 1, 2019, and August 31, 2022. Cognitive outcomes were measured 12 months after hospital discharge using the telephone-based Montreal Cognitive Assessment (T-MoCA) and additional neuropsychological tests. Functional status, employment, and quality of life were evaluated using validated questionnaires and scales.

Results: Among 30 patients who received V-V ECMO and were contacted for long-term outcomes, the mean age was 48 years, and 11(36.7%) were female. Cognitive assessment at 12 months post hospital discharge revealed mild cognitive impairment with 8(26.67%) patients exhibiting a t-MoCA score < 18. Standardized Z-scores for executive function, working memory, and verbal fluency were used to measure how far a score deviates from the mean with 8(26.67%), 2(8.7%), and 4(16.66%) patients scoring < -1.5 respectively, indicating impairment. For functional independence, 21(70%) of patients reported impairments in 1 or more basic ADLs, 12(40%) reported impairments in 1 or more instrumental daily activities. In quality-of-life assessments, 11(36.67%) patients reported moderate to extreme depression/anxiety. At 12 months, 13(43%) survivors returned to work and 9(30%) were receiving disability income. When compared to non-ECMO ICU survivors from CO-PILOT, ECMO patients exhibited similar cognitive and functional impairments, indicating the long-term outcomes of patients who receive ECMO are comparable to other critically ill patients.

Conclusions: Even at 12 months post hospital discharge, survivors of V-V ECMO continue to face considerable long-term cognitive and functional impairments similar to other ICU survivors, affecting their quality of life and functional status.