Feasibility and Safety of Early Physical Therapy and Active Mobilization for Patients on Extracorporeal Membrane Oxygenation.
Physical therapy (PT) and early mobilization for critically ill patients have been popularized to decrease the length of hospital stay and to improve the quality of life after discharge. We reviewed our experience of PT and active mobilization for patients on extracorporeal membrane oxygenation (ECMO) in terms of its technical feasibility and safety. Study endpoints were safety events during PT and PT interruptions due to unstable vital signs. Of the eight patients, one patient (12.5%) had venoarterial ECMO, seven patients (87.5%) had venovenous ECMO. Among total of 62 sessions including 31 sessions (50%) of passive range of motion and electrical muscle stimulation, 17 sessions (27.4%) were performed for patients who were sitting in bed or on the edge of bed, two sessions (3.2%) were for strengthening in sitting, 11 sessions (18%) were for standing or marching in place, one session (2%) was for walking. Eight sessions (13%) of sitting were supported with invasive mechanical ventilation. Three sessions (5%) were stopped due to tachycardia (n = 1) and tachypnea (n = 2). There was no clinically significant adverse event in patients. Thus, early PT and mobilization for patients on ECMO might be feasible and safe at an experienced ECMO center.
From the *Physical Therapy Part, Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Seoul, Republic of Korea; †Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; ‡Department of Physical and Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea; §Division of Pulmonary and Critical Care Medicine, Department of Medicine, ¶Department of Critical Care Medicine, ‖Department of Cardiology, #Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
YoungJun
Y
Ko
Yang Hyun
YH
Cho
Yun Hee
YH
Park
Hyun
H
Lee
Gee Young
GY
Suh
Jeong Hoon
JH
Yang
Chi-Min
CM
Park
Kyeongman
K
Jeon
Chi Ryang
CR
Chung
D000368:Aged; D004434:Early Ambulation; D015199:Extracorporeal Membrane Oxygenation / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome