Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jan 20;9(2):34.
doi: 10.3390/jcdd9020034.

Modalities of Exercise Training in Patients with Extracorporeal Membrane Oxygenation Support

Christos Kourek  1 , Serafim Nanas  1 , Anastasia Kotanidou  1 , Vasiliki Raidou  1 , Maria Dimopoulou  1 , Stamatis Adamopoulos  2 , Andreas Karabinis  3 , Stavros Dimopoulos  1   3
Affiliations
Review

Modalities of Exercise Training in Patients with Extracorporeal Membrane Oxygenation Support

Christos Kourek et al. J Cardiovasc Dev Dis. .

Abstract

The aim of this qualitative systematic review is to summarize and analyze the different modalities of exercise training and its potential effects in patients on extracorporeal membrane oxygenation (ECMO) support. ECMO is an outbreaking, life-saving technology of the last decades which is being used as a gold standard treatment in patients with severe cardiac, respiratory or combined cardiorespiratory failure. Critically ill patients on ECMO very often present intensive care unit-acquired weakness (ICU-AW); thus, leading to decreased exercise capacity and increased mortality rates. Early mobilization and physical therapy have been proven to be safe and feasible in critically ill patients on ECMO, either as a bridge to lung/heart transplantation or as a bridge to recovery. Rehabilitation has beneficial effects from the early stages in the ICU, resulting in the prevention of ICU-AW, and a decrease in episodes of delirium, the duration of mechanical ventilation, ICU and hospital length of stay, and mortality rates. It also improves functional ability, exercise capacity, and quality of life. Rehabilitation requires a very careful, multi-disciplinary approach from a highly specialized team from different specialties. Initial risk assessment and screening, with appropriate physical therapy planning and exercise monitoring in patients receiving ECMO therapy are crucial factors for achieving treatment goals. However, more randomized controlled trials are required in order to establish more appropriate individualized exercise training protocols.

Keywords: assessment; early mobilization; exercise training; extracorporeal membrane oxygenation (ECMO); intensive care unit-acquired weakness (ICU-AW); rehabilitation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Screening and assessment of critically ill patients on ECMO support prior, during and after rehabilitation [48]. ECMO, extracorporeal membrane oxygenation; RASS, Richmond Agitation and Sedation Scale; RR, respiratory rate; DVT, deep vein thrombosis; PE, pulmonary embolism; ICU, intensive care unit.
Figure 2
Figure 2
Tools for assessment of functional status in critically ill patients on ECMO support [79]. ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit.
See this image and copyright information in PMC

References

    1. Herridge M.S., Tansey C.M., Matté A., Tomlinson G., Diaz-Granados N., Cooper A., Guest C.B., Mazer C.D., Mehta S., Stewart T.E., et al. Functional disability 5 years after acute respiratory distress syndrome. N. Engl. J. Med. 2011;364:1293–1304. doi: 10.1056/NEJMoa1011802. - DOI - PubMed
    1. Morris P.E., Goad A., Thompson C., Taylor K., Harry B., Passmore L., Ross A., Anderson L., Baker S., Sanchez M., et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit. Care Med. 2008;36:2238–2243. doi: 10.1097/CCM.0b013e318180b90e. - DOI - PubMed
    1. Stiller K. Physiotherapy in intensive care: An updated systematic review. Chest. 2013;144:825–847. doi: 10.1378/chest.12-2930. - DOI - PubMed
    1. Hodgson C.L., Berney S., Harrold M., Saxena M., Bellomo R. Clinical review: Early patient mobilization in the ICU. Crit. Care. 2013;17:207. doi: 10.1186/cc11820. - DOI - PMC - PubMed
    1. Schweickert W.D., Pohlman M.C., Pohlman A.S., Nigos C., Pawlik A.J., Esbrook C.L., Spears L., Miller M., Franczyk M., Deprizio D., et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomised controlled trial. Lancet. 2009;373:1874–1882. doi: 10.1016/S0140-6736(09)60658-9. - DOI - PMC - PubMed

LinkOut - more resources