• J. Cardiothorac. Vasc. Anesth. · Mar 2020

    Observational Study

    The Effect of Sedation on Long-Term Psychological Impairment After Extracorporeal Life Support.

    • Michael D McDonald, Meghan Lane-Fall, Todd A Miano, Madeline Henry, Colby Gallagher, Rachel Hadler, Krzysztof Laudanski, Emily J Mackay, Asad A Usman, and Jacob Gutsche.
    • Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, PA.
    • J. Cardiothorac. Vasc. Anesth. 2020 Mar 1; 34 (3): 663-667.

    ObjectiveThis retrospective study aimed to identify the association between long-term psychological impairment and total sedation received during venovenous extracorporeal life support (VV-ECLS) for acute respiratory failure (ARF).DesignThis observational retrospective study compared characteristics between patients with and without long-term psychological morbidity at long-term follow-up after VV-ECLS for ARF.SettingA single institutional experience in a quaternary referral academic medical center in the United States.PatientsPatients who received VV-ECLS for ARF between January 1, 2015, and April 1, 2017, were identified for selection. Presence of psychiatric morbidity (anxiety and/or depression) was determined with the Hospital Anxiety and Depression Subscale battery at long-term follow-up.InterventionsNo interventions were made during this retrospective observational study.Measurements And Main ResultsA total of 42 patients (21 male, 21 female, median age 49 [interquartile range {IQR} 36-57]) completed a telephone interview a median of 14.6 (IQR 7.7-21.1) months after ECLS decannulation. Cohorts were defined as possessing any psychiatric morbidity (anxiety and/or depression) as defined by the Hospital Anxiety and Depression Subscale battery (n = 22 [52%]) versus no psychiatric morbidity (n = 20 [48%]) at long-term follow-up. Patients who had clinically significant psychiatric morbidity received a median of 15.0 (IQR 11.0-17.0) days of continuous intravenous sedation compared with patients who had no psychiatric morbidity, who received a median of 10.0 (IQR 6.5-13.5) days of intravenous sedation; (p = 0.02).ConclusionsThis retrospective analysis identified a significant association between the presence of long-term post-VV-ECLS psychiatric symptoms and the total number of days of intravenous sedation.Copyright © 2019 Elsevier Inc. All rights reserved.

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