Introduction: Previous work has described impaired long-term functional recovery in survivors of acute hypoxemic respiratory failure (AHRF) including patients who were managed on ECMO. 

Aims: We sought to determine whether the functional recovery of patients with AHRF managed with veno-venous ECMO (VV-ECMO) differs from patients who did not receive ECMO. 

Methods: We conducted a multi-center retrospective cohort study of adults cannulated for VV-ECMO or admitted to the ICU for AHRF. Enrolled patients presented to ICU follow-up clinic between April 2020 and January 2023. Hospital Anxiety and Depression Scale (HADS), PCL-5, and Montreal Cognitive Assessment (MoCA), PFTs, and 6-minute walk test (6MWT) were obtained at follow-up.

Results: Sixty-four patients were included in this analysis, 34 received VV-ECMO and 30 did not (non-ECMO). ECMO patients were younger (35 v. 50 years, p<0.01), had a higher SOFA score (6 v. 4, p<0.01) and were less likely to have COVID-19 (58 v. 90%, p<0.01). ECMO patients had a significantly longer median duration of hospitalization (46 v. 22 days, p<0.01), ICU stay (29 v. 14 days, p<0.01), and mechanical ventilation (21 v. 12 days, p <0.04). At follow-up, there was no difference in HADS, PCL-5, or MOCA between the ECMO and non-ECMO group. There were no significant differences in pulmonary function tests or 6MWT when comparing the ECMO to non-ECMO patients after adjusting for potential confounders. This remained true in a subgroup analysis of patients with COVID-19. 

Conclusion: Potentially relevant to resource allocation and prognostication, we found no difference in functional recovery when comparing AHRF patients managed with and without VV-ECMO.