{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:16:30Z","timestamp":1790644590054,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) for hemodynamic support is on the rise. Not much is known about the impact of extracorporeal membrane oxygenation (ECMO) and its complications on long-term survival and quality of life. Methods: In this single-center, cross-sectional study, we evaluated the survival and quality of life in patients treated with VA ECMO between May 2009 and July 2019. Follow-up was conducted between November 2019 and January 2020. Results: Overall, 118 patients were evaluated in this study. Of the 37 patients who were alive at hospital discharge, 32 answered the EuroQol-5 dimensional\u20145-level questionnaire (EQ-5D-5L). For patients discharged alive from the hospital, mean survival was 8.1 years, 8.4 years for cardiogenic shock, and 5.0 years for patients with refractory cardiac arrest. EQ-5D-5L index value of ECMO survivors was not significantly different from the general age-matched population. Neurologic complications and major bleeding during index hospitalization limit long-term quality of life. Conclusions: Patients treated with VA ECMO have high in-hospital mortality, with extracorporeal membrane oxygenation cardio-pulmonary resuscitation patients being at higher risk of early death. However, once discharged from the hospital, most patients remain alive with a reasonable quality of life.<\/jats:p>","DOI":"10.3390\/jcm11216452","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T06:42:17Z","timestamp":1667371337000},"page":"6452","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Long-Term Survival and Quality of Life in Non-Surgical Adult Patients Supported with Veno-Arterial Extracorporeal Oxygenation"],"prefix":"10.3390","volume":"11","author":[{"given":"Toma\u017e","family":"Cankar","sequence":"first","affiliation":[{"name":"Department of Intensive Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihela","family":"Krepek","sequence":"additional","affiliation":[{"name":"Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinos","family":"Kosmopoulos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine and Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rad\u0161el","sequence":"additional","affiliation":[{"name":"Department of Intensive Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7131-2015","authenticated-orcid":false,"given":"Demetris","family":"Yannopoulos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine and Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Noc","sequence":"additional","affiliation":[{"name":"Department of Intensive Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toma\u017e","family":"Goslar","sequence":"additional","affiliation":[{"name":"Department of Intensive Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.resuscitation.2016.12.009","article-title":"ECMO Cardio-Pulmonary Resuscitation (ECPR), trends in survival from an international multicentre cohort study over 12-years","volume":"112","author":"Richardson","year":"2017","journal-title":"Resuscitation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.carrev.2022.06.267","article-title":"Sixteen-year national trends in use and outcomes of VA-ECMO in cardiogenic shock","volume":"44","author":"Syed","year":"2022","journal-title":"Cardiovasc. Revascularization Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1093\/eurheartj\/ehz363","article-title":"Management of cardiogenic shock complicating myocardial infarction: An update 2019","volume":"40","author":"Thiele","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/MAT.0000000000001344","article-title":"Extracorporeal Cardiopulmonary Resuscitation in Adults. Interim Guideline Consensus Statement from the Extracorporeal Life Support Organization","volume":"67","author":"Richardson","year":"2021","journal-title":"ASAIO J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1161\/CIRCULATIONAHA.119.042173","article-title":"Improved Survival with Extracorporeal Cardiopulmonary Resuscitation Despite Progressive Metabolic Derangement Associated with Prolonged Resuscitation","volume":"141","author":"Bartos","year":"2020","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/MAT.0000000000000475","article-title":"Extracorporeal Life Support Organization Registry International Report 2016","volume":"63","author":"Thiagarajan","year":"2017","journal-title":"ASAIO J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1093\/ejcts\/ezy374","article-title":"Extracorporeal membrane oxygenation for refractory cardiogenic shock: Patient survival and health-related quality of life","volume":"55","author":"Salmela","year":"2019","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.resuscitation.2017.04.014","article-title":"A Pre-Hospital Extracorporeal Cardio Pulmonary Resuscitation (ECPR) strategy for treatment of refractory out hospital cardiac arrest: An observational study and propensity analysis","volume":"117","author":"Lamhaut","year":"2017","journal-title":"Resuscitation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/S0140-6736(08)60958-7","article-title":"Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: An observational study and propensity analysis","volume":"372","author":"Chen","year":"2008","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.jtcvs.2015.05.070","article-title":"Survival and quality of life after extracorporeal life support for refractory cardiac arrest: A case series","volume":"150","author":"Anselmi","year":"2015","journal-title":"J. Thoracic Cardiovasc. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.jacc.2017.06.059","article-title":"Coronary Artery Disease in Patients with Out-of-Hospital Refractory Ventricular Fibrillation Cardiac Arrest","volume":"70","author":"Yannopoulos","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.resuscitation.2014.09.010","article-title":"Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial)","volume":"86","author":"Stub","year":"2015","journal-title":"Resuscitation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.4244\/EIJ-D-17-01014","article-title":"Outcome after revascularisation of acute myocardial infarction with cardiogenic shock on extracorporeal life support","volume":"13","author":"Overtchouk","year":"2018","journal-title":"EuroIntervention"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s00392-016-1068-8","article-title":"Outcome of elderly undergoing extracorporeal life support in refractory cardiogenic shock","volume":"106","author":"Graf","year":"2017","journal-title":"Clin. Res. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.hjc.2020.04.013","article-title":"Patients treated with venoarterial extracorporeal membrane oxygenation have different baseline risk and outcomes dependent on indication and route of cannulation","volume":"62","author":"Kosmopoulos","year":"2020","journal-title":"Hell J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1007\/s40273-018-0623-8","article-title":"Is EQ-5D-5L Better Than EQ-5D-3L? A Head-to-Head Comparison of Descriptive Systems and Value Sets from Seven Countries","volume":"36","author":"Janssen","year":"2018","journal-title":"Pharmacoeconomics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1097\/00003246-199811000-00016","article-title":"Use of the SOFA score to assess the incidence of organ dysfunction\/failure in intensive care units","volume":"26","author":"Vincent","year":"1998","journal-title":"Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/00003246-198510000-00009","article-title":"APACHE II: A severity of disease classification system","volume":"13","author":"Knaus","year":"1985","journal-title":"Crit. Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2246","DOI":"10.1093\/eurheartj\/ehv194","article-title":"Predicting survival after ECMO for refractory cardiogenic shock: The survival after veno-arterial-ECMO (SAVE)-score","volume":"36","author":"Schmidt","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"EuroQol Group (1990). EuroQol\u2014A new facility for the measurement of health-related quality of life. Health Policy, 16, 199\u2013208.","DOI":"10.1016\/0168-8510(90)90421-9"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta21620","article-title":"The Age of BLood Evaluation (ABLE) randomised controlled trial: Description of the UK-funded arm of the international trial, the UK cost\u2013utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-ca","volume":"21","author":"Walsh","year":"2017","journal-title":"Health Technol. Assess."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1007\/s00134-002-1345-z","article-title":"Quality of life after intensive care\u2014Evaluation with EQ-5D questionnaire","volume":"28","author":"Granja","year":"2002","journal-title":"Intensive Care Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.hlc.2018.06.1044","article-title":"Long-Term Survival and Health-Related Quality of Life in Adults After Extra Corporeal Membrane Oxygenation","volume":"28","author":"Roll","year":"2019","journal-title":"Heart Lung Circ."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual Life Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1093\/ejcts\/ezx100","article-title":"Long-term survival and quality of life after extracorporeal life support: A 10-year report\u2020","volume":"52","author":"Camboni","year":"2017","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s40273-019-00811-7","article-title":"Valuation of EQ-5D-5L Health States in Poland: The First EQ-VT-Based Study in Central and Eastern Europe","volume":"37","author":"Golicki","year":"2019","journal-title":"Pharmacoeconomics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"191","DOI":"10.5114\/aoms.2015.52126","article-title":"EQ-5D-5L Polish population norms","volume":"13","author":"Golicki","year":"2017","journal-title":"Arch. Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.jcrc.2019.05.011","article-title":"Venoarterial extracorporeal membrane oxygenation: A systematic review of selection criteria, outcome measures and definitions of complications","volume":"53","author":"Burrell","year":"2019","journal-title":"J. Crit. Care"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Chen, K.H., Chen, Y.T., Yeh, S.L., Weng, L.C., and Tsai, F.C. (2018). Changes in quality of life and health status in patients with extracorporeal life support: A prospective longitudinal study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0196778"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.resuscitation.2018.03.036","article-title":"Health related quality of life after extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest","volume":"127","author":"Spangenberg","year":"2018","journal-title":"Resuscitation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1111\/jan.12943","article-title":"Health status and quality of life of survivors of extra corporeal membrane oxygenation: A cross-sectional study","volume":"72","author":"Hsieh","year":"2016","journal-title":"J. Adv. Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1002\/ehf2.12433","article-title":"Health-related quality of life after extracorporeal membrane oxygenation: A single centre\u2019s experience","volume":"6","author":"Karlsen","year":"2019","journal-title":"ESC Heart Fail."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1177\/0267659118815291","article-title":"Long-term quality of life in patients treated with extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock","volume":"34","author":"Norkiene","year":"2019","journal-title":"Perfusion"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1097\/CCM.0b013e31816f7cf7","article-title":"Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock","volume":"36","author":"Combes","year":"2008","journal-title":"Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.hrtlng.2019.08.016","article-title":"Long-term health-related quality of life of adult patients treated with extracorporeal membrane oxygenation (ECMO): An integrative review","volume":"48","author":"Knudson","year":"2019","journal-title":"Heart Lung"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1097\/MAT.0000000000001095","article-title":"Long-Term Survival, Posttraumatic Stress, and Quality of Life post Extracorporeal Membrane Oxygenation","volume":"66","author":"Harley","year":"2020","journal-title":"ASAIO J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/aas.13065","article-title":"Good quality of life before cardiac arrest predicts good quality of life after resuscitation","volume":"62","author":"Hellevuo","year":"2018","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"R202","DOI":"10.1186\/cc11811","article-title":"Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia","volume":"16","author":"Hodgson","year":"2012","journal-title":"Crit. Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"18","DOI":"10.20452\/pamw.2638","article-title":"General population reference values for 3-level EQ-5D (EQ-5D-3L) questionnaire in Poland","volume":"125","author":"Golicki","year":"2015","journal-title":"Pol. Arch. Med. Wewn."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1186\/cc14632","article-title":"Hospital anxiety and depression after ICU survival: Results of a post-ICU aftercare program","volume":"19","author":"Ramnarain","year":"2015","journal-title":"Crit. Care"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/21\/6452\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:06:26Z","timestamp":1760144786000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/21\/6452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,31]]},"references-count":40,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["jcm11216452"],"URL":"https:\/\/doi.org\/10.3390\/jcm11216452","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,31]]}}}