Table 8.
Consensus recommendations on long-term neurological outcomes and follow-ups for ECMO patients
| Recommendations | References |
|---|---|
| 5. Long-term outcomes and quality of life* | |
| 5.1. Pre-discharge care | |
| 5.1.1 Clinical examination and use of the modified Rankin Scale before the discharge are recommended. Neuroimaging (preferably conventional MRI brain after decannulation) for those with neurological or cognitive dysfunction is reasonable | 59,60 |
| 5.1.2 Outpatient care planning, with careful consideration of the timing of visits (preferably at 3, 6, and 12 months) after discharge, location of visits (preferably at ECMO clinics or neurologist), and ECMO-related comorbidities and complications (vascular, myopathy, chronic infection, cardiopulmonary recovery) is recommended | 59,60 |
| 5.1.3 Comprehensive education and psychosocial support for patients, family members, and caretakers are recommended | 59,60,92 |
| 5.1.4 Assessment and formulation of a nutritional plan for optimal recovery is recommended | |
| 5.2. Post-discharge care | |
| 5.2.1 Serial neurological assessments and quality of life assessments are recommended | 59,60 |
| 5.2.2 In patients with neurological complications, clinical examination by a neurological specialist, neuroimaging (preferably MRI), and other tailored examinations/tests are recommended | 59,60 |
| 5.2.3 Follow up with disease-specific specialists that are tailored to the underlying disease and comorbidities, including pulmonologist, cardiologist, neurologist, nephrologist, gastroenterologist, and hematologist, is recommended as needed | 59 |
| 5.2.4 Follow up with the primary care physician is recommended | 60 |
| 5.2.5 Establishing a centralized and secure data repository to store patient data that can be shared with outpatient healthcare providers is recommended | 93 |
ECMO: extracorporeal membrane oxygenation; MRI: magnetic resonance imaging.
*
Results of the Delphi survey results are available in the Supplementary Material.