Long-term health-related quality of life in pediatric ECMO survivors: a prospective controlled study.

IntroductionExtracorporeal Membrane Oxygenation (ECMO) is an intervention used for neonates, infants, and children with severe respiratory or cardiac failure. While ECMO has been linked to improved survival rates, it is also associated with neurological complications and potential long-term effects on health-related quality of life (HRQoL), when compared to healthy peers. In order to better characterize the longer-term outcomes of ECMO itself, this study evaluated HRQoL, as well as neurodevelopmental, motor, and cognitive outcomes in pediatric ECMO survivors in comparison to a matched control group. MethodsWe conducted a prospective cross-sectional matched case-control study at Nantes University Hospital, France. Forty-two ECMO survivors supported with ECMO from January 2014 to January 2023 were matched with 42 pediatric intensive care unit (PICU) survivors. HRQoL was assessed using the PedsQL 4.0 Generic Core Questionnaire. Neurodevelopmental outcomes were evaluated with the Age and Stage Questionnaire (ASQ) or the Strengths and Difficulties Questionnaire (SDQ), motor function with the Global Motor Function Classification Score (GMFCS), and executive functioning with the Behavior Rating Inventory of Executive Function (BRIEF). ResultsOverall HRQoL scores were slightly lower in the ECMO group, with a mean adjusted difference for HRQoL total score of -5.4, 95%CI -10.6 to -0.3, p=0.040. Notably, physical functioning was lower in the ECMO group, with a mean adjusted difference of -9.6, 95%CI -16.8 to -2.5, p=0.009. Amongother outcome measures reported, executive function complaints affected approximately one thirds of the cohort and were associated with impaired HRQoL. Among other variables tested, parental stress index and parental level of education were also associated with HRQoL total score or subdomains. ConclusionECMO survivors often experience slight changes in their health-related quality of life as compared with a matched control cohort, particularly in physical functioning. This study also identifies cognitive and executive functioning impairments that may persist long after discharge from the PICU.