PURPOSE: Extracorporeal membrane oxygenation (ECMO) is an increasingly prevalent 
treatment for acute respiratory failure (ARF). To evaluate the impact of ECMO 
support on long-term outcomes for critically ill adults with ARF.
METHODS: We searched electronic databases 1948 through to November 30 2016; 
selected controlled trials or observational studies of critically ill adults 
with acute respiratory distress syndrome, examining long-term morbidity 
specifically health-related quality of life (HRQL); 2 authors independently 
selected studies, extracted data, and assessed methodological quality.
ANALYSIS: Of the 633 citations, 1 randomized controlled trial and 5 
observational studies met the selection criteria. Overall quality of 
observational studies was moderate to high (mean score on Newcastle-Ottawa 
scale, 7.2/9; range, 6-8). In 3 studies (n = 245), greater decrements in HRQL 
were seen for survivors of ECMO when compared to survivors of conventional 
mechanical ventilation (CMV) as measured by the Short Form 36 (SF-36) scores 
([ECMO-CMV]: 5.40 [95% confidence interval, CI, 4.11 to 6.68]). As compared to 
CMV survivors, those who received ECMO experienced significantly less 
psychological morbidity (2 studies; n = 217 [ECMO-CMV]: mean weighted difference 
[MWD], -1.31 [95% CI, -1.98 to -0.64] for depression and MWD, -1.60 [95% CI, 
-1.80 to -1.39] for anxiety).
CONCLUSIONS: Further studies are required to confirm findings and determine 
prognostic factors associated with more favorable outcomes in survivors of ECMO.