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Practice Guideline
. 2025 Mar 1;71(3):187-199.
doi: 10.1097/MAT.0000000000002375. Epub 2025 Jan 30.

Extracorporeal Life Support Organization 2024 Guideline for Early Rehabilitation or Mobilization of Adult Patients on Extracorporeal Membrane Oxygenation

Stephen Ramsey  1 , Ahmed Labib Shehatta  2   3 , Kollengode Ramanathan  4   5 , Kiran Shekar  6   7   8 , Daniel Brodie  9 , Rodrigo Diaz  10 , Abigail Roberts  11 , Sherene Cruz  12 , Carol Hodgson  12   13   14   15 , Bishoy Zakhary  16
Affiliations
Practice Guideline

Extracorporeal Life Support Organization 2024 Guideline for Early Rehabilitation or Mobilization of Adult Patients on Extracorporeal Membrane Oxygenation

Stephen Ramsey et al. ASAIO J. .

Abstract

This Extracorporeal Life Support Organization guideline describes early rehabilitation or mobilization of patients on extracorporeal membrane oxygenation (ECMO). The guideline describes useful and safe practices put together by an international interprofessional team with extensive experience in the field of ECMO and ECMO rehabilitation or mobilization. The guideline is not intended to define the delivery of care or substitute sound clinical judgment. The guideline is subject to regular revision as new scientific evidence becomes available.

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Conflict of interest statement

Disclosure: C.H. received research support from the NHMRC in Australia. She sits on the Executive and Scientific Committee of the International ECMO Network (ECMONet). She is leading an NHMRC-funded trial of early rehabilitation of patients during ECMO (NCT05003609). K.R. is the Extracorporeal Life Support Organization (ELSO) Chair of the Publications Committee. D.B. receives research support from and consults for LivaNova. He has been on the medical advisory boards for Xenios, Medtronic, Inspira, and Cellenkos. He is the President-elect of the ELSO and the Chair of the Executive Committee of the International ECMO Network (ECMONet) and he writes for UpToDate. K.S. received research support from the Metro North Hospital and Health Service. He is a member of the Scientific Committee of the International ECMO Network and Chair of the ELSO Guidelines & Protocol Committee. B.Z. is the ELSO Chair of Education. The other authors have no conflicts of interest to report.

References

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    1. Devlin JW, Skrobik Y, Gélinas C, et al.: Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 46: e825–e873, 2018.
    1. Bein T, Bischoff M, Brückner U, et al.: S2e guideline: Positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders: Revision 2015: S2e guideline of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). Anaesthesist 64(suppl 1): 1–26, 2015.
    1. Aquim EE, Bernardo WM, Buzzini RF, et al.: Brazilian guidelines for early mobilization in intensive care unit. Rev Bras Ter Intensiva 31: 434–443, 2019.
    1. Agency for Healthcare Research and Quality (AHRQ). Early mobility guide for reducing ventilator-associated events in mechanically ventilated patients. AHRQ Publ No. 1617-0018-4-EF. Baltimore, USA, Johns Hopkins Medicine/Armstrong Institute for Patient Safety and Quality. 2017. Available at: https://www.ahrq.gov/hai/tools/mvp/technical-bundles-early-mobility.html . Accessed February 20, 2023.

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