Early mobilization in adult patients using extracorporeal membrane oxygenation
Revisão - número e225481 - publicado 19 de setembro de 2023
DOI:
https://doi.org/10.33233/rbfex.v22i1.5481Keywords:
extracorporeal membrane oxygenation, early ambulation, physical therapyAbstract
Introduction: Extracorporeal membrane oxygenation is used in patients with respiratory failure and severe cardiovascular complications with a prognosis of reversal. Early mobilization in these patients can prevent the complications of immobility, such as decreased functional capacity, delirium, physical deficits, respiratory and psychological. A well-trained multidisciplinary team with extensive knowledge about extracorporeal membrane oxygenation is essential to optimize patient care. Objective: The objective of this narrative literature review is to relate the repercussions of early mobilization in these patients, to optimize care and reduce unfavorable events related to immobility. Methods: It is an integrative literature review, with research through analysis of articles on the Pubmed platform, from the years 2014 to 2022, applying the terms: ECMO Rehabilitation, Mobilization ECMO, ECMO and physiotherapy and ECMO Physiotherapy. Results: 26 articles were found, 09 selected for the study, in a total of 1390 patients on extracorporeal membrane oxygenation who received at least one physiotherapy session, from activities in bed to walking. There was no change in relevant hemodynamic parameters, regardless of the location of the cannula, making early mobilization feasible. Conclusion: Early mobilization in patients undergoing extracorporeal membrane oxygenation is beneficial for a better clinical outcome within institutions, which requires the involvement of the entire aligned and engaged multidisciplinary team.
References
Dias AS, Ramos FF, Silva PE. Fraqueza muscular do doente crítico. In: editor: George Jerre Vieira Sarmento, editor associado: André Luiz Lisboa Cordeiro. Fisioterapia motora aplicada ao paciente crítico: do diagnóstico à intervenção. 2ª ed. Santana de Parnaíba, SP: Manole; 2022. p.1-24
Griffiths RD, Hall JB. Intensive care unit-acquired weakness. Crit Care Med. 2010;38(3):779-87. doi: 10.1097/ccm.0b013e3181cc4b53
França EÉT, Ferrari F, Fernandes P, Cavalcanti R, Duarte A, Martinez BP, et al. Fisioterapia em pacientes críticos adultos: recomendações do Departamento de Fisioterapia da Associação de Medicina Intensiva Brasileira. Rev Bras Ter Intensiva. 2012;24(1):6-22. doi: 10.1590/S0103-507X2012000100003
De Jonghe B. Paresis acquired in the intensive care unit. a prospective multicenter study. JAMA. 2002;288(22):2859. doi: 10.1001/jama.288.22.2859
Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Eng J Med. 2008;358(13):1327-35. doi: 10.1056/NEJMoa070447
Aquim EE, Bernardo WM, Buzzini RF, Azeredo NSG, Cunha LS, Damasceno MCP, et al. Brazilian guidelines for early mobilization in intensive care unit. Rev Bras Ter Intensiva. 2019;31(4). doi: 10.5935/0103-507X.20190084
Squiers JJ, Lima B, DiMaio JM. Contemporary extracorporeal membrane oxygenation therapy in adults: Fundamental principles and systematic review of the evidence. The Journal of Thoracic and Cardiovascular Surgery. [Internet]. 2016 Jul [cited 2021 jun 2];152(1):20-32. Disponível em: https://www.jtcvs.org/action/showPdf?pii=S0022-5223%2816%2900424-4
Romano TG, Mendes PV, Park M, Costa ELV. Extracorporeal respiratory support in adult patients. J Bras Pneumol. 2017;43(1):60-70. doi:10.1590/S1806-37562016000000299
Garcia JP, Iacono A, Kon ZN, Griffith BP. Ambulatory extracorporeal membrane oxygenation: A new approach for bridge-to-lung transplantation. The Journal of Thoracic and Cardiovascular Surgery. 2010;139(6):e137-9. doi: 10.1016/j.jtcvs.2009.12.021.
Hayes K, Holland AE, Pellegrino VA, Young M, Paul E, Hodgson CL. Early rehabilitation during extracorporeal membrane oxygenation has minimal impact on physiological parameters: A pilot randomized controlled trial. Australian Critical Care. 2021;34(3):217-25. doi: 10.1016/j.aucc.2020.07.008
Abrams D, Javidfar J, Farrand E, Mongero LB, Agerstrand CL, Ryan P, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Critical Care. 2014;18(1):R38. doi: 10.1186/cc13746
Abrams D, Madahar P, Eckhardt CM, Short B, Yip NH, Parekh M, et al. Early mobilization during ECMO for cardiopulmonary failure in adults: factors associated with intensity of treatment. Ann Am Thorac Soc. 2021;19(1):90-98. doi: 10.1513/AnnalsATS.202102-151OC
Ko Y, Cho YH, Park YH, Lee H, Suh GY, Yang JH, et al. Feasibility and safety of early physical therapy and active mobilization for patients on extracorporeal membrane oxygenation. ASAIO Journal. 2015;61(5):564-8. doi: 10.1097/MAT.0000000000000239
Munshi L, Kobayashi T, DeBacker J, Doobay R, Telesnicki T, Lo V, et al. Intensive care physiotherapy during extracorporeal membrane oxygenation for acute respiratory distress syndrome. Ann Am Thorac Soc. 2017;14(2):246-53. doi: 10.1513/AnnalsATS.201606-484OC
Wells CL, Forrester J, Vogel J, Rector R, Tabatabai A, Herr D. Safety and feasibility of early physical therapy for patients on extracorporeal membrane oxygenator. Crit Care Med. 2018;46(1):53-9. doi: 10.1097/CCM.0000000000002770
Mayer KP, Pastva AM, Du G, Hatchett SP, Chang M, Henning AN, et al. Mobility levels with physical rehabilitation delivered during and after extracorporeal membrane oxygenation: a marker of illness severity or an indication of recovery? Phys Ther. 2021;102(3). doi: 10.1093/ptj/pzab301
Cucchi M, Mariani S, Piero ME, Ravaux JM, Kawczynski MJ, Di Mauro M, et al. Awake extracorporeal life support and physiotherapy in adult patients: A systematic review of the literature. Perfusion. 2022;026765912210960. doi: 10.1177/02676591221096078
Marhong JD, DeBacker J, Viau-Lapointe J, Munshi L, Del Sorbo L, Burry L, et al. Sedation and mobilization during venovenous extracorporeal membrane oxygenation for acute respiratory failure. Crit Care Med. 2017;45(11):1893-9. doi: 10.1097/CCM.0000000000002702
Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, et al. Improving long-term outcomes after discharge from intensive care unit. Crit Care Med. 2012;40(2):502-9. doi: 10.1097/CCM.0b013e318232da75
Adler J, Malone D. Early mobilization in the intensive care unit: a systematic review. Cardiopulm Phys Ther J. 2012;23(1):5-13. doi: 10.1097/01823246-201223010-00002
Rickelmann C, Knoblauch DJ. Incorporating safe patient-handling techniques to mobilize our most complex patients on extra corporeal membrane oxygenation. Crit Care Nurs Q. 2018;41(3):272-81. doi: 10.1097/CNQ.0000000000000206
Hodson CL, Hayes K, Linnane M, Transtad O. Early mobilization during extracorporeal membrane oxygenation was safe and feasible: a pilot randomized controlled trial. Intensive Care Med. 2020;46(5):1057-9. doi: 10.1007/s00134-020-05994-8
Lange DW, Sikma MA, Meulenbelt J. Extracorporeal membrane oxygenation in the treatment of poisoned patients. Clin Toxicol. 2013;51(5):385-93. doi: 10.3109/15563650.2013.800876
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Bruna Pereira Gomes, Camila Aparecida Correa, Érica Nasatto Morais, Juliana Fernanda de Lima e Silva, Marcos Vinícius Costa e Silva, Vanessa de Aquino Aleixo Marques , Jaqueline Aparecida Almeida Spadari, Giulliano Gardenghi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms: Authors retain the copyright and grant the journal the right of first publication, with the work simultaneously licensed under the Creative Commons Attribution License which allows the sharing of work with acknowledgment of authorship and initial publication in this magazine; Authors are authorized to assume additional contracts separately, for non-exclusive distribution of the version of the work published in this journal (eg, publish in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal; Authors are allowed and encouraged to publish and distribute their work online (eg, in institutional repositories or on their personal page) at any point before or during the editorial process, as this can generate productive changes as well as increase impact and citation of published work (See The Effect of Open Access).
