Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study.
Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study.
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DOI：
10.1186/cc13746
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发表时间：
2014-02-27
期刊：
影响因子：
--
通讯作者：
Brodie D
中科院分区：
文献类型：
--
作者：
Abrams D;Javidfar J;Farrand E;Mongero LB;Agerstrand CL;Ryan P;Zemmel D;Galuskin K;Morrone TM;Boerem P;Bacchetta M;Brodie D
危重疾病是神经肌肉无力和身体功能受损的公认原因。物理治疗（PT）已被证明对危重患者安全有效。这种干预措施对接受体外膜肺氧合（ECMO）患者的影响尚未得到很好的表征。我们描述了主动 PT 对 ECMO 患者的可行性和影响。我们对一所大学医院的重症监护病房连续 100 名接受 ECMO 的患者进行了回顾性队列研究。在接受 ECMO 的 100 名患者中，35 名（35%）参加了主动 PT； 19 作为移植的桥梁，16 作为恢复的桥梁。 ECMO 的持续时间为 14.3±10.9 天。患者在使用 ECMO 时接受了 7.2±6.5 次 PT 疗程。在 PT 期间，18 名患者 (51%) 下床活动（中位距离 175 英尺，范围 4 至 2,800），9 名患者服用血管加压药。在接受 ECMO 期间，23 名患者摆脱了有创机械通气。在 16 名康复患者中，14 名（88%）存活出院； 10 名接受移植手术的患者 (53%) 存活至移植，其中 9 名 (90%) 存活至出院。 23名幸存者中，13人（57%）直接回家，8人（35%）接受急性康复，2人（9%）接受亚急性康复。没有发生 PT 相关并发症。当使用经验丰富的多学科团队时，可以安全可靠地为 ECMO 患者实现主动 PT（包括步行）。需要更多的研究来确定 PT 的障碍以及对该人群的生存和长期功能、神经认知结果的影响。
Critical illness is a well-recognized cause of neuromuscular weakness and impaired physical functioning. Physical therapy (PT) has been demonstrated to be safe and effective for critically ill patients. The impact of such an intervention on patients receiving extracorporeal membrane oxygenation (ECMO) has not been well characterized. We describe the feasibility and impact of active PT on ECMO patients. We performed a retrospective cohort study of 100 consecutive patients receiving ECMO in the medical intensive care unit of a university hospital. Of the 100 patients receiving ECMO, 35 (35%) participated in active PT; 19 as bridge to transplant and 16 as bridge to recovery. Duration of ECMO was 14.3 ± 10.9 days. Patients received 7.2 ± 6.5 PT sessions while on ECMO. During PT sessions, 18 patients (51%) ambulated (median distance 175 feet, range 4 to 2,800) and 9 patients were on vasopressors. Whilst receiving ECMO, 23 patients were liberated from invasive mechanical ventilation. Of the 16 bridge to recovery patients, 14 (88%) survived to discharge; 10 bridge to transplant patients (53%) survived to transplantation, with 9 (90%) surviving to discharge. Of the 23 survivors, 13 (57%) went directly home, 8 (35%) went to acute rehabilitation, and 2 (9%) went to subacute rehabilitation. There were no PT-related complications. Active PT, including ambulation, can be achieved safely and reliably in ECMO patients when an experienced, multidisciplinary team is utilized. More research is needed to define the barriers to PT and the impact on survival and long-term functional, neurocognitive outcomes in this population.
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DOI：
10.1016/j.jtcvs.2011.07.029
发表时间：
2011-10-01
影响因子：
6
作者：
Garcia, Jose P.;Kon, Zachary N.;Griffith, Bartley P.
通讯作者：
Griffith, Bartley P.
影响因子：
4.2
作者：
Paden, Matthew L.;Conrad, Steven A.;Thiagarajan, Ravi R.
通讯作者：
Thiagarajan, Ravi R.
影响因子：
8.3
作者：
Abrams, Darryl C;Brenner, Keith;Brodie, Daniel
通讯作者：
Brodie, Daniel
影响因子：
4.2
作者：
Camboni, Daniele;Philipp, Alois;Mueller, Thomas
通讯作者：
Mueller, Thomas
影响因子：
158.5
作者：
Herridge, Margaret S.;Tansey, Catherine M.;Cheung, Angela M.
通讯作者：
Cheung, Angela M.