Physical rehabilitation of patients in the intensive care unit requiring extracorporeal membrane oxygenation: a small case series.
Publication/Presentation Date
2-1-2013
Abstract
BACKGROUND AND PURPOSE: Neuromuscular weakness and impaired physical function are common and long-lasting complications experienced by intensive care unit (ICU) survivors. There is growing evidence that implementing rehabilitation therapy shortly after ICU admission improves physical function and reduces health care utilization. Recently, there is increasing interest and utilization of extracorporeal membrane oxygenation (ECMO) to support patients with severe respiratory failure. Patients receiving ECMO are at great risk for significant physical impairments and pose unique challenges for delivering rehabilitation therapy. Consequently, there is a need for innovative examples of safely and feasibly delivering active rehabilitation to these patients.
CASE DESCRIPTION: This case report describes 3 patients with respiratory failure requiring ECMO who received physical rehabilitation to illustrate and discuss relevant feasibility and safety issues.
OUTCOMES: In case 1, sedation and femoral cannulation limited rehabilitation therapy while on ECMO. In the 2 subsequent cases, minimizing sedation and utilizing a single bicaval dual lumen ECMO cannula placed in the internal jugular vein allowed patients to be alert and participate in active physical therapy while on ECMO, illustrating feasible rehabilitation techniques for these patients.
DISCUSSION: Although greater experience is needed to more fully evaluate the safety of rehabilitation on ECMO, these initial cases are encouraging. We recommend systematically and prospectively tracking safety events and patient outcomes during rehabilitation on ECMO to provide greater evidence in this area.
Volume
93
Issue
2
First Page
248
Last Page
255
ISSN
1538-6724
Published In/Presented At
Rahimi, Rod A et al. “Physical rehabilitation of patients in the intensive care unit requiring extracorporeal membrane oxygenation: a small case series.” Physical therapy vol. 93,2 (2013): 248-55. doi:10.2522/ptj.20120336
Disciplines
Medicine and Health Sciences
PubMedID
23104895
Department(s)
Department of Medicine
Document Type
Article