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Minerva Anestesiologica 2019 September;85(9):989-94

DOI: 10.23736/S0375-9393.19.13287-7


language: English

Effects of a physiotherapic program in patients on veno-venous extracorporeal membrane oxygenation: an 8-year single-center experience

Manuela BONIZZOLI 1 , Chiara LAZZERI 1, Andrea DRAGO 1, Laura TADINI BONINSEGNI 1, Martina DONATI 1, Simona DI VALVASONE 1, Antonio PESENTI 2, Adriano PERIS 1

1 Unit of Intensive Care, Regional ECMO Referral Center, Careggi University Hospital, Florence, Italy; 2 Unit of Critical Care and Emergency, Department of Anesthesia, Maggiore Polyclinic Hospital, Ca’ Granda IRCCS and Foundation, Milan, Italy

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.

KEY WORDS: Respiratory distress syndrome, adult; Extracorporeal membrane oxygenation; Physical therapy modalities; Prognosis

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