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Critical Care
Published in: Critical Care 1/2014

Open Access 01-02-2014 | Research

Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study

Authors: Darryl Abrams, Jeffrey Javidfar, Erica Farrand, Linda B Mongero, Cara L Agerstrand, Patrick Ryan, David Zemmel, Keri Galuskin, Theresa M Morrone, Paul Boerem, Matthew Bacchetta, Daniel Brodie

Published in: Critical Care | Issue 1/2014

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Abstract

Introduction

Critical illness is a well-recognized cause of neuromuscular weakness and impaired physical functioning. Physical therapy (PT) has been demonstrated to be safe and effective for critically ill patients. The impact of such an intervention on patients receiving extracorporeal membrane oxygenation (ECMO) has not been well characterized. We describe the feasibility and impact of active PT on ECMO patients.

Methods

We performed a retrospective cohort study of 100 consecutive patients receiving ECMO in the medical intensive care unit of a university hospital.

Results

Of the 100 patients receiving ECMO, 35 (35%) participated in active PT; 19 as bridge to transplant and 16 as bridge to recovery. Duration of ECMO was 14.3 ± 10.9 days. Patients received 7.2 ± 6.5 PT sessions while on ECMO. During PT sessions, 18 patients (51%) ambulated (median distance 175 feet, range 4 to 2,800) and 9 patients were on vasopressors. Whilst receiving ECMO, 23 patients were liberated from invasive mechanical ventilation. Of the 16 bridge to recovery patients, 14 (88%) survived to discharge; 10 bridge to transplant patients (53%) survived to transplantation, with 9 (90%) surviving to discharge. Of the 23 survivors, 13 (57%) went directly home, 8 (35%) went to acute rehabilitation, and 2 (9%) went to subacute rehabilitation. There were no PT-related complications.

Conclusions

Active PT, including ambulation, can be achieved safely and reliably in ECMO patients when an experienced, multidisciplinary team is utilized. More research is needed to define the barriers to PT and the impact on survival and long-term functional, neurocognitive outcomes in this population.
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Metadata
Title
Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
Authors
Darryl Abrams
Jeffrey Javidfar
Erica Farrand
Linda B Mongero
Cara L Agerstrand
Patrick Ryan
David Zemmel
Keri Galuskin
Theresa M Morrone
Paul Boerem
Matthew Bacchetta
Daniel Brodie
Publication date
01-02-2014
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2014
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc13746

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