Psychological Outcomes of Family Caregivers During Hospitalization of ECMO Survivors

Sunday, February 23, 2025

11:45am – 12:45pm Eastern Time

Location: Connections Central Theater 1

Ann Warren, PhD

Baylor University Medical Center
Baylor Scott & White Research Institute

Disclosure(s): No relevant financial relationship(s) to disclose.
SB

Shakeira Brown, N/A

Clinical Research Coordinator
n/a

Disclosure information not submitted.
AE

Alexis Evans, NA

Clinical Research Coordinator
Baylor Scott & White Research Institute

Disclosure information not submitted.
CB

Claire Bird, PhD

Research Investigator
Baylor Scott & White Research Institute

Disclosure information not submitted.
MD

Megan Douglas, PhD

Clinical Research Psychologist
Walter Reed Army Institute of Research-West

Disclosure information not submitted.
KV

Katherine Vandervest, MD

Attending Physician
Baylor Scott & White Health

Disclosure information not submitted.
CR

Chandni Raiyani, MPH

Biostatistician
Baylor Scott & White Research Institute

Disclosure information not submitted.
Valerie Danesh, PhD, RN, FCCM (she/her/hers)

Baylor Scott and White Health

Disclosure information not submitted.

Disclosure(s):

Ann Warren, PhD: No relevant financial relationship(s) to disclose.

Introduction: Extracorporeal membrane oxygenation (ECMO) is life support for critically ill patients hospitalized with severe cardiac and/or respiratory failure. Adverse psychological outcomes can extend to family caregivers of patients receiving ECMO. We examined psychological outcomes in family caregivers of ECMO patients during hospitalization and at 3-months follow-up.

Methods: Family caregivers of ECMO patients were consented from four hospitals in a large health system in the southwestern United States (IRB#21-384). Psychological outcomes were measured longitudinally (hospitalization and 3-month follow-up), including the Posttraumatic Stress Disorder Checklist (PCL-5), Caregiver Burden Scale (CBS), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-8), and Health Related Quality of Life (EQ-5D).

Results: In our sample of 64 caregivers, most were women (74%), white (75%), and non-Hispanic (85%). During hospitalization, 58 (12%) family caregivers screened positive for possible PTSD (mean 16.1, SD =15.1). At 3-month follow-up, 42 (21%) of family caregivers screened positive for possible PTSD (mean 20.6, SD=20.3). Nearly half of family caregivers reported clinically relevant caregiver burden ( average of 40.4 during hospitalization and 43.7 at 3-month follow-up). Screening scores for anxiety were similar during hospitalization (mean 7.8, SD=6.3) and at 3-month follow-up (mean 7.9, SD=7.0) suggesting a screening prevalence of 32% at baseline and 26% at follow-up. Screening scores for depression were higher at 3-months (8.2) compared with hospitalization (7.0), with 43% screening positive for possible depression. Similarly, health-related quality of life was worse at 3-month follow-up (66.4) compared with baseline assessments (73.8) .

Conclusions: When screened for PTSD, anxiety and depression, family caregivers of ECMO survivors had clinically relevant scores. Screening for PTSD and depression suggests that symptoms worsened at 3-month follow-up, consistent with high rates of caregiver burden and worsening health-related quality of life. Interventions are needed to address the psychological health of family caregivers for ECMO survivors along the ICU care continuum from intra-hospitalization assessment through the vulnerable ICU recovery period after hospital discharge.