Manuela Bonizzoli1, Chiara Lazzeri2, Andrea Drago2, Laura Tadini Boninsegni2, Martina Donati2, Simona Di Valvasone2, Antonio Pesenti3, Adriano Peris2. 1. Unit of Intensive Care, Regional ECMO Referral Center, Careggi University Hospital, Florence, Italy - manuelabonizzoli@gmail.com. 2. Unit of Intensive Care, Regional ECMO Referral Center, Careggi University Hospital, Florence, Italy. 3. Unit of Critical Care and Emergency, Department of Anesthesia, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy.
Abstract
BACKGROUND: To date, there is no agreement on the timing to perform a physical session in patients on veno-venous extracorporeal membrane oxygenation (VV-ECMO). We aimed to assess whether early physiotherapy (within the first week from ECMO start) could affect in-ICU mortality. METHODS: Our retrospective observational study included 101 adults supported on VV ECMO from 2009 to 2016, consecutively admitted at our ECMO referral Center in Florence (Italy). Clinical data right before ECMO start were collected for all patients. The level of mobilization using the ICU mobility scale was recorded on the first session and at discharge. RESULTS: Early physiotherapy (within the first week) was more frequently initiated in patients with lower BMI (P=0.013) and it was associated with lower duration of ECMO support (P=0.03), mechanical ventilation (P=0.001) and length of stay (P=0.001). In-ICU mortality was not different between the two subgroups. CONCLUSIONS: In patients on VV-ECMO support, physiotherapy is feasible and safe and that early physiotherapy, initiated within the first week from ECMO start, is associated with shorter duration of ECMO support and ICU length of stay.
BACKGROUND: To date, there is no agreement on the timing to perform a physical session in patients on veno-venous extracorporeal membrane oxygenation (VV-ECMO). We aimed to assess whether early physiotherapy (within the first week from ECMO start) could affect in-ICU mortality. METHODS: Our retrospective observational study included 101 adults supported on VV ECMO from 2009 to 2016, consecutively admitted at our ECMO referral Center in Florence (Italy). Clinical data right before ECMO start were collected for all patients. The level of mobilization using the ICU mobility scale was recorded on the first session and at discharge. RESULTS: Early physiotherapy (within the first week) was more frequently initiated in patients with lower BMI (P=0.013) and it was associated with lower duration of ECMO support (P=0.03), mechanical ventilation (P=0.001) and length of stay (P=0.001). In-ICU mortality was not different between the two subgroups. CONCLUSIONS: In patients on VV-ECMO support, physiotherapy is feasible and safe and that early physiotherapy, initiated within the first week from ECMO start, is associated with shorter duration of ECMO support and ICU length of stay.
Authors: Stephan Braune; Patrick Bojes; Anne Mecklenburg; Federico Angriman; Gerold Soeffker; Katja Warnke; Dirk Westermann; Stefan Blankenberg; Mathias Kubik; Hermann Reichenspurner; Stefan Kluge Journal: Ann Intensive Care Date: 2020-12-01 Impact factor: 6.925