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

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 ox...

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Autores principales: Abrams, Darryl, Javidfar, Jeffrey, Farrand, Erica, Mongero, Linda B, Agerstrand, Cara L, Ryan, Patrick, Zemmel, David, Galuskin, Keri, Morrone, Theresa M, Boerem, Paul, Bacchetta, Matthew, Brodie, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056162/
https://www.ncbi.nlm.nih.gov/pubmed/24571627
http://dx.doi.org/10.1186/cc13746
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author Abrams, Darryl
Javidfar, Jeffrey
Farrand, Erica
Mongero, Linda B
Agerstrand, Cara L
Ryan, Patrick
Zemmel, David
Galuskin, Keri
Morrone, Theresa M
Boerem, Paul
Bacchetta, Matthew
Brodie, Daniel
author_facet Abrams, Darryl
Javidfar, Jeffrey
Farrand, Erica
Mongero, Linda B
Agerstrand, Cara L
Ryan, Patrick
Zemmel, David
Galuskin, Keri
Morrone, Theresa M
Boerem, Paul
Bacchetta, Matthew
Brodie, Daniel
author_sort Abrams, Darryl
collection PubMed
description 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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spelling pubmed-40561622014-06-14 Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study Abrams, Darryl Javidfar, Jeffrey Farrand, Erica Mongero, Linda B Agerstrand, Cara L Ryan, Patrick Zemmel, David Galuskin, Keri Morrone, Theresa M Boerem, Paul Bacchetta, Matthew Brodie, Daniel Crit Care Research 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. BioMed Central 2014 2014-02-27 /pmc/articles/PMC4056162/ /pubmed/24571627 http://dx.doi.org/10.1186/cc13746 Text en Copyright © 2014 Abrams et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Abrams, Darryl
Javidfar, Jeffrey
Farrand, Erica
Mongero, Linda B
Agerstrand, Cara L
Ryan, Patrick
Zemmel, David
Galuskin, Keri
Morrone, Theresa M
Boerem, Paul
Bacchetta, Matthew
Brodie, Daniel
Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
title Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
title_full Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
title_fullStr Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
title_full_unstemmed Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
title_short Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
title_sort early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056162/
https://www.ncbi.nlm.nih.gov/pubmed/24571627
http://dx.doi.org/10.1186/cc13746
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