PMID- 31312911 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 2110-5820 (Print) IS - 2110-5820 (Electronic) IS - 2110-5820 (Linking) VI - 9 IP - 1 DP - 2019 Jul 16 TI - Long-term neurocognitive outcome is not worsened by of the use of venovenous ECMO in severe ARDS patients. PG - 82 LID - 10.1186/s13613-019-0556-1 [doi] LID - 82 AB - BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is associated with a significant morbidity. There is the need to investigate long-term cognitive outcome among ARDS survivors treated with VV-ECMO. We aimed to compare the prevalence of long-term cognitive dysfunction and neuropsychological impairment using a highly specific test in severe ARDS survivors treated or not treated with VV-ECMO. METHODS: Severe ARDS survivors treated between 2011 and 2017 in an ECMO Regional Referral Center were prospectively evaluated 2 years after their ICU discharge. Patients underwent an in-person interview and examination. The primary outcome was cognitive function, assessed by the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV). Secondary outcomes included anxiety, depression, post-traumatic stress disorder (PTSD) and quality-of-life. RESULTS: We investigated 40 consecutive patients surviving from severe ARDS treated (N = 22) or not (N = 18) with VV-ECMO at a median [interquartile range] of 20 [17-22] and 22 [18-23] months after ICU discharge, respectively. Regarding the main outcome, cognitive function was below normal ranges in 12 (55%) ECMO patients and 10 (56%) non-ECMO patients (p = 0.95). Eight (36%) ECMO patients had moderate-to-severe depressive symptoms as compared with 7 (39%) non-ECMO patients (p = 0.87). Twelve (55%) ECMO patients and eight (44%) non-ECMO patients had moderate-to-severe anxiety symptoms (p = 0.53). Seven (33%) ECMO patients and eight (44%) non-ECMO patients presented a PTSD (p = 0.48). Health-related quality of life did not differ between the two groups. CONCLUSIONS: Using the WAIS-IV, VV-ECMO treatment does not appear to worsen long-term cognitive and neuropsychological outcomes in severe ARDS patients. FAU - Sylvestre, Aude AU - Sylvestre A AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Medecine Intensive Reanimation, Chemin des Bourrely, 13015, Marseille, France. AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Adda, Melanie AU - Adda M AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Medecine Intensive Reanimation, Chemin des Bourrely, 13015, Marseille, France. AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Maltese, Francois AU - Maltese F AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Medecine Intensive Reanimation, Chemin des Bourrely, 13015, Marseille, France. AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Lannelongue, Ariane AU - Lannelongue A AD - Departement d'Anesthesie Reanimation, Centre Hospitalo Universitaire Caremeau, 30029, Nimes, France. FAU - Daviet, Florence AU - Daviet F AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Medecine Intensive Reanimation, Chemin des Bourrely, 13015, Marseille, France. AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Parzy, Gabriel AU - Parzy G AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Medecine Intensive Reanimation, Chemin des Bourrely, 13015, Marseille, France. AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Coiffard, Benjamin AU - Coiffard B AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Medecine Intensive Reanimation, Chemin des Bourrely, 13015, Marseille, France. AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Roch, Antoine AU - Roch A AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Service des Urgences, 13015, Marseille, France. FAU - Loundou, Anderson AU - Loundou A AD - Unite d'Aide Methodologique a la Recherche Clinique - Assistance Publique - Hopitaux de Marseille, Marseille, France. AD - EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Baumstarck, Karine AU - Baumstarck K AD - Unite d'Aide Methodologique a la Recherche Clinique - Assistance Publique - Hopitaux de Marseille, Marseille, France. AD - EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. FAU - Papazian, Laurent AU - Papazian L AD - Assistance Publique - Hopitaux de Marseille, Hopital Nord, Medecine Intensive Reanimation, Chemin des Bourrely, 13015, Marseille, France. laurent.papazian@ap-hm.fr. AD - Centre d'Etudes et de Recherches sur les Services de Sante et qualite de vie EA 3279, Faculte de medecine, Aix-Marseille Universite, 13005, Marseille, France. laurent.papazian@ap-hm.fr. LA - eng PT - Journal Article DEP - 20190716 PL - Germany TA - Ann Intensive Care JT - Annals of intensive care JID - 101562873 PMC - PMC6635548 OTO - NOTNLM OT - Cognitive impairment OT - Long-term cognitive and psychiatric morbidity OT - Long-term neuropsychological outcome OT - PTSD OT - WAIS-IV COIS- The authors declare that they have no competing interests. EDAT- 2019/07/18 06:00 MHDA- 2019/07/18 06:01 PMCR- 2019/07/16 CRDT- 2019/07/18 06:00 PHST- 2019/05/15 00:00 [received] PHST- 2019/07/06 00:00 [accepted] PHST- 2019/07/18 06:00 [entrez] PHST- 2019/07/18 06:00 [pubmed] PHST- 2019/07/18 06:01 [medline] PHST- 2019/07/16 00:00 [pmc-release] AID - 10.1186/s13613-019-0556-1 [pii] AID - 556 [pii] AID - 10.1186/s13613-019-0556-1 [doi] PST - epublish SO - Ann Intensive Care. 2019 Jul 16;9(1):82. doi: 10.1186/s13613-019-0556-1.