Sepsis Clinical Trial
Follow-up after treatment with Extracorporeal Membrane Oxygenation (ECMO) at the ECMO Center
Karolinska.
Patients: adult survivors treated with ECMO for severe refractory respiratory failure at
least 5 years earlier.
Investigations: brain and pulmonary radiographic morphology, cognitive testing, pulmonary
function testing, exercise tolerance, quality of life and mood disorder screening.
All adult patients treated at the ECMO Center Karolinska between 1995 and July 2009 were
screened for eligibility in January 2014. Patients living abroad (including non-Swedish
citizens), patients treated for non-respiratory conditions, diseased patients and patients
with a known pre-ECMO mental handicap were excluded.
Eligible patients were contacted, and patients who agreed to participate gave their written
informed consent. All studied patients underwent the same study protocol during a day at the
hospital, including a clinical interview, MRI scan of the brain, HRCT scan of the thorax,
pulmonary function testing, neuropsychological examination, walking test, self assessment
questionnaires for quality of life, anxiety, depression and post-traumatic stress.
Patient charts were reviewed for relevant clinical information, including age, gender, ECMO
mode (venovenous or venoarterial), time in hospital, on ECMO, non-ECMO ICU and on mechanical
ventilation; preexisting diseases, blood gas values and ventilator settings before
initiation of ECMO treatment. Hand written clinical data from the patients´ charts from
every hour with ECMO treatment was reviewed for ventilator settings, lung volumes, mean
arterial pressure, hemoglobin, lactate and oxygenation parameters during an observation
period, which was defined as the first 10 days on ECMO (or the entire treatment period if
shorter than 10 days). This information was added to a digital database for the purpose of
this study.
At the time of ECMO treatment, arterial hemoglobin oxygen saturation was measured by
peripheral pulse oximetry from the right ear, finger or nose. Venous preoxygenator lactate
and venous saturation values were used as indicators of sufficient (lactate < 2 mmol l-1 ,
SvO2 ≥ 70%) or insufficient tissue perfusion.
;
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