Physiotherapy for Patients on Awake Extracorporeal Membrane Oxygenation: A Systematic Review.
OBJECTIVE
Extracorporeal membrane oxygenation (ECMO) is used as temporary life support in subjects with potentially reversible respiratory/cardiac failure. The principal purpose of this review was to assess the characteristics and potential advantages of physiotherapeutic interventions in subjects on awake ECMO support.


METHODS
Seven databases were interrogated: we searched titles, abstracts and keywords using the Medical Subject Headings terms 'extracorporeal membrane oxygenation' and 'rehabilitation' linked with the Boolean operator 'AND'.


CONCLUSIONS
In total, 216 citations were retrieved. Nine citations satisfied our inclusion criteria and were subjected to full-text analysis. The numbers of patients enrolled in the included studies (most of which were case series) were low (n = 52). We found no prospective studies or randomized controlled trials. Overall, subjects on awake ECMO usually received a combination of passive and active physiotherapy, and most achieved an acceptable degree of autonomy after treatment. Emerging research in the field affords preliminary evidence supporting the safety of early mobilization and ambulation in patients on awake veno-venous ECMO support. Copyright © 2015 John Wiley & Sons, Ltd.
Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, University Hospital S.Orsola-Malpighi, Bologna, Italy.
Massimiliano
M
Polastri
Department of Cardiac-Thoracic and Vascular Diseases, Cardiac Surgery and Transplantation, University Hospital S.Orsola-Malpighi, Bologna, Italy.
Antonino
A
Loforte
Department of Cardiac-Thoracic and Vascular Diseases, Thoracic Surgery and Transplantation, University Hospital S.Orsola-Malpighi, Bologna, Italy.
Andrea
A
Dell'Amore
Department of Specialistic-Diagnostic and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Stefano
S
Nava
D003243:Consciousness / Q000502:physiology; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D026741:Physical Therapy Modalities / Q000639:trends*; D016896:Treatment Outcome
extracorporeal membrane oxygenation; intensive care units; lung transplantation; physical therapy modalities; walking