(654) Family Perspectives on Driving Status Three Months After Extracorporeal Membrane Oxygenation

Introduction: Driving after critical illness is a functional outcome important to patients. Decisions about driving resumption after critical illness are often subjective decisions by patients and families. Family member perspectives on decisions for driving resumption or driving cessation after critical illness may or may not align with the patient’s perspectives and priorities. Patients requiring extracorporeal membrane oxygenation (ECMO) for severe illness are often recovering from severe physical deconditioning and adapting to new onset disability after hospital discharge. Important vulnerabilities for ECMO survivors and their families include decisions on if and when to resume driving.

Methods: This multi-site longitudinal cohort study includes 3-month follow-up assessments of driving-related concerns and driving-related decisions from family members of patients requiring ECMO for severe cardiopulmonary failure or cardiac arrest refractory to conventional treatments.

Results: Perspectives on driving status at 3 months after hospital discharge are presented from 11 family members of ECMO survivors. Most family member participants reported concerns related to driving resumption after critical illness, by describing shared concerns between family and the ECMO survivor (n=8, 73%). Three of 11 family members described that the ECMO survivor was substantially less concerned or not concerned about driving safety, including significant interpersonal conflict related to driving status. At 3 months after hospital discharge, few family members reported driving status discussions with healthcare providers (n=2, 18%).

Conclusions: Driving status after ECMO is an emerging functional outcome relevant to critical illness recovery. Perspectives on driving decisions specific to ECMO recovery have not been previously reported. Despite a modest sample size, this report of family member perspectives highlights the relevance of driving-related discussions amongst patients, family members, and their clinicians during critical illness recovery. Furthermore, results demonstrate a spectrum of driving decisions during the first 3 months of ECMO recovery, with both concordance and discordance on driving resumption decisions observed by family members.