title: Physical Therapist-Led Ambulatory Rehabilitation for Patients Receiving CentriMag Short-Term Ventricular Assist Device Support: Retrospective Case Series.
abstract: OBJECTIVE
  Short-term ventricular assist device (VAD) support is used in the intensive care unit (ICU) to support individuals in end-stage heart failure prior to heart transplantation or implantation of a long-term left VAD. The literature investigating the feasibility, safety, and content of rehabilitation for this patient group is lacking. This report retrospectively describes the rehabilitation strategy, safety measures used, and nature of any adverse events and, therefore, the feasibility of this practice.
  Ten individuals (80% male) admitted to the ICU in critical cardiogenic shock required support via a short-term VAD. A prerehabilitation risk assessment was used to reduce the risk of cannula dislodgement. The therapeutic strategy was a stepwise progression of exercises, mobilization, and ambulation.
  
  
  RESULTS
  Retrospective inspection of the case notes showed 330 rehabilitation sessions (X̅=33, SD=18.1, range=16-72) were performed and progressed to ambulation on 71 occasions (X̅=7.1, SD=7.7, range=1-27). Distance ambulated ranged from 7 to 1,200 m (X̅=157.7, SD=367.3). The Chelsea Critical Care Physical Assessment Tool (CPAx) score for 7 patients improved from a median of 0 (interquartile range=0-1) on day 1 to a median peak score of 39 (interquartile range=37-42). There were 8 episodes of minor adverse events (2.4% incidence rate), including 7 of transient low VAD flows. There were no major adverse events.
  
  
  CONCLUSIONS
  Early rehabilitation and ambulation of recipients of short-term VAD support was safe and feasible. Recipients demonstrated improvements in physical function (CPAx score) while the VAD was in situ.
authors.affiliation: L. McGarrigle, MSc, Department of Cardiothoracic Transplantation, University Hospital of South Manchester NHSFT, Southmoor Road, Wythenshawe M239LT, United Kingdom. laura.mcgarrigle@uhsm.nhs.uk.
authors.forename: Laura
authors.initials: L
authors.lastname: McGarrigle
authors.affiliation: J. Caunt, PhD, Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Caunt
mesh_terms: D000293:Adolescent; D000328:Adult; D003422:Critical Care; D005081:Exercise Therapy / Q000009:adverse effects; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000534:rehabilitation*; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000534:rehabilitation* / Q000601:surgery; D013997:Time Factors; D016138:Walking; D055815:Young Adult