Extracorporeal Membrane Oxygenation for Adults and Children with Severe Respiratory Failure: A Qualitative Rapid Review


( Last Updated : June 22, 2021)
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1365-000

Details


Question

1. What are the experiences and perspectives of adults and children with severe respiratory failure and their families on being offered, receiving, and recovering from ECMO?

2. What are the experiences and perspectives of health care providers on offering, providing, and supporting patients’ recovery after ECMO for severe respiratory failure?


Key Message

This review used a framework analysis to synthesize 9 included studies on the perspectives and experiences of patients, family members, and providers on extracorporeal membrane oxygenation (ECMO).

Patients’ perspectives on their experiences are limited due to their sedated status when treated with ECMO.

Supporting a relative treated with ECMO is stressful for family members. They feel anxious and worried about their relative because of the patient’s critical condition, and they struggle to juggle multiple roles at work and home while supporting their relative receiving ECMO.

Family members often have to travel to see their critically ill relative. Financial and logistical support for temporary relocation near the ECMO centre may ease the burden of travel.

Family members benefit from clear and frequent communication from health care providers as a source of support and reassurance while their loved ones are being treated with ECMO. There may be a role for informal or formal peer support for family members of patients receiving ECMO.

Clinicians’ decisions to offer, continue, and withdraw ECMO are based on their assessments of prognostic factors from patients’ medical histories and clinical conditions. Additional clinical research and/or refinements of prognostic guidance for ECMO may further support evidence-informed decision-making around ECMO.

Patients, family members, and clinical team members may differ in their assessment of the limits of ECMO treatment and the decision to transition from active treatment to the withdrawal of life support. These findings point to the role of ethical considerations and processes when engaging in transitioning to end-of-life support in the provision of ECMO.

After discharge, patients who had received ECMO and their family members continued to have feelings of anxiety, intrusive thoughts, and a need to process the event. ECMO programs that can offer continued or ongoing support or referral for patients and their family members’ mental health may help address these needs.