ECMO-RECOVERY
Evaluating a Recovery Intervention via a digital platform (app) to improve disability in adult patients after extracorporeal membrane oxygenation (ECMO)
A multicentre, randomised controlled, parallel-group, two-sided superiority trial evaluating a digitally supported recovery intervention to reduce disability at 6 months for adult survivors of VA or VV ECMO.
Aim:
To determine whether a multicomponent digital intervention led by a recovery coordinator, reduces disability as measured by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) at 6 months following randomisation, compared to standard care.
Rationale:
Critically ill patients who require extracorporeal membrane oxygenation (ECMO) are some of the sickest patients in the hospital system. Although ECMO is lifesaving and supports critically ill patients with cardiac or respiratory failure, long-term health outcomes for adult survivors remain quite poor. Many ECMO survivors experience persistent physical, cognitive, and psychological impairments following discharge with two-third of them being dead or disabled at 6 months after ECMO commencement. Furthermore, since ECMO is only delivered in a limited number of specialised tertiary centres in Australia, patients often have significant geographical constraints returning for follow-up. Many patients return to communities with limited access to care coordination or ECMO-informed clinicians resulting in fragmented care.
ECMO survivors who are deemed stable and expected to be discharged home are recruited on the ward before hospital discharge into the 6-month ECMO-RECOVERY trial.
The intervention includes:
- Access to a digital e-platform (app)
- Virtual support from a hospital-based recovery coordinator
- Virtual visits through video calling
- Ability to set and monitor recovery goals
- Access to tailored educational resources
- Recommendations to GP based on questionnaire responses and goal achievements to inform ongoing multidisciplinary care
The trial aims to test the ECMO-RECOVERY intervention across a 4-year period with a sample of 227 patients who undergo ECMO at 8 Australian hospitals.
A Parallel Process Evaluation will be undertaken to understand the barriers and facilitators influencing the implementation and fidelity of the ECMO-RECOVERY intervention.
Progress:
The ECMO-RECOVERY trial is in the start-up stage with recruitment slated to commence in August 2026. E-platform development is currently underway. HREC approval has been obtained from the Alfred Hospital Ethics Committee and site governance applications are being finalised for submission.
Trial registration:
The study has been registered with the Australian New Zealand Clinical Trials Registry: ACTRN12626000460303