Background

Post-traumatic stress disorder (PTSD) is a common long-term outcome after intensive care of critical illness.

Objectives

Assess the prevalence and factors associated to PTSD after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support.

Methods

Retrospective analysis of admission data and cross-sectional assessment of PTSD symptoms in adult survivors from admission requiring VA-ECMO support in a referral hospital. People were screened through abbreviated Impact of Event Scale-6 (IES-6).

Results

Out of 135 VA-ECMO implants performed from 2013 to 2020, 48 (35.6%) patients survived the admission. After a median follow-up of 31.4 [36] months, 34 survivors responded the questionnaire. All patients required sedation and invasive mechanical ventilation. Up to 29.4% of patients had PTSD symptoms. Patients with altered IES-6 items had passed a longer time since admission in ICCU (44±15 vs 30±20 months, p = 0.034). No baseline characteristic or admission-related variables were correlated with IES-6 except the lower time under mechanical ventilation (6.5 [8.5] vs. 8.5 [21] days, p = 0.044).

Conclusions

Survivors from admission requiring VA-ECMO support show high prevalence of PTSD symptoms, appearing more frequently when more time has elapsed since admission. Special attention should be paid to psychological symptoms after VA-ECMO support.

中文翻译：

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静脉-动脉体外膜氧合器支持后的创伤后应激障碍症状

背景

创伤后应激障碍（PTSD）是危重病重症监护后常见的长期结果。

目标

评估静脉-动脉体外膜肺氧合 (VA-ECMO) 支持后与 PTSD 相关的患病率和因素。

方法

入院数据的回顾性分析和对转诊医院需要 VA-ECMO 支持的成年幸存者的 PTSD 症状的横断面评估。人们通过事件量表 6 (IES-6) 的缩写影响进行筛选。

结果

在 2013 年至 2020 年进行的 135 例 VA-ECMO 植入物中，48 例 (35.6%) 患者在入院后存活。中位随访 31.4 [36] 个月后，34 名幸存者回答了问卷。所有患者都需要镇静和有创机械通气。高达 29.4% 的患者有 PTSD 症状。IES-6 项目改变的患者自 ICCU 入院以来的时间更长（44±15 个月 vs 30±20 个月，p  = 0.034）。除了机械通气时间较短（6.5 [8.5] 对 8.5 [21] 天， p  = 0.044）外，没有基线特征或入院相关变量与 IES-6 相关。

结论

入院后需要 VA-ECMO 支持的幸存者表现出 PTSD 症状的高患病率，当入院后经过的时间越长，出现的频率越高。VA-ECMO支持后应特别注意心理症状。