Rationale: To assess the long term outcome and quality of life of patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) for refractory hypoxemia. Methods: Retrospective observational study with prospective health related quality of life (HRQoL) assessment was conducted in ARDS patients who had ECMO as a rescue therapy for refractory hypoxemia from January 2009 Jan 2011 in two tertiary Australian centres. Survival and quality of life assessment were measured using the Short-Form 36 (SF-36). Results: Twenty-four patients (mean age 36.3 ± 12 years) with ARDS receiving ECMO for refractory hypoxemia were studied. Eighteen (75%) patients were retrieved from other intensive care units (ICUs) by a dedicated ECMO retrieval team. Fourteen (58%) had H1N1 influenza A-associated pneumonitis. Twenty-one (88%) patients survived to hospital discharge and twelve of the fourteen patients with H1N1 survived (86%). Health related quality of life were evaluated for 18 of the 21 (86%) long-term survivors (assessment at median 278 days). Mean SF-36 scores were significantly lower across all domains compared to age and sex matched Australian norms, and were lower than previously described ARDS survivors in the domains of general health, mental health, vitality, social function, role emotional and mental health. One patient had long-term disability as a result of ICU acquired weakness. Only 28% of survivors had returned to previous work levels at the time of follow-up. Conclusions: This ARDS cohort had a high survival rate (88%) after use of ECMO support for refractory hypoxemia. Long term survivors had similar physical and mental health but decreased vitality and social function compared to other ARDS survivors and an unexpectedly poor return to work. This abstract is funded by: The Alfred Hospital Trust NHMRC Fellowship APP1035050 Am J Respir Crit Care Med 185;2012:A2287 Internet address: www.atsjournals.org Online Abstracts Issue
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