Extracorporeal membrane oxygenation (ECMO) is in-creasingly being used in patients with respiratory failure[12,13]. Patients receiving venovenous or venoarterialECMO have traditionally been considered too unstablefor active physical therapy, frequently are heavily sedated,and occasionally are administered neuromuscular blockingagents. However, the ability to ambulate while receivingECMO support has been facilitated by advances in extra- corporeal technology and cannulation techniques [14-17].Additionally, mobilization may be facilitated when ECMOallows for weaning from invasive mechanical ventilation.
Although patients receiving ECMO as bridge totransplantation (BTT) are obvious targets for early re-habilitation to maintain their transplant candidacy, thoserequiring ECMO as a bridge to recovery (BTR) from acute respiratory failure should theoretically benefit similarlyfrom early mobilization, though there are few publishedreports of success in such populations [18-21]. We de-scribe our center’s experience with a multidisciplinary ap- proach to early physical therapy, including ambulation, inpatients requiring ECMO as either BTR from acute re-spiratory failure or BTT in cases of end-stage lung disease.
Total Lift Bed ~ ECMO
More Patient Inclusion: Don't let tradional barriers keep you forom including patients in your Early Mobility Program. This graph is an example from Colombia as to how they increases patient inclusion over time.
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4. Wang D, Zhou X, Liu X, Sidor B, Lynch J, Zwischenberger JB: Wang-Zwischedouble lumen cannula-toward a percutaneous and ambulatoryparacorporeal artificial lung. ASAIO J 2008, 54:606–611
5. Javidfar J, Brodie D, Wang D, Ibrahimiye AN, Yang J, Zwischenberger JB,Sonett J, Bacchetta M: Use of bicaval dual-lumen catheter for adultvenovenous extracorporeal membrane oxygenation. Ann Thorac Surg2011, 91:1763–1768.
6. Khoshbin E, Roberts N, Harvey C, Machin D, Killer H, Peek GJ, Sosnowski AW,Firmin RK: Poly-methyl pentene oxygenators have improved gasexchange capability and reduced transfusion requirements in adultextracorporeal membrane oxygenation. ASAIO J 2005, 51:281–287.
7. Javidfar J, Brodie D, Costa J, Miller J, Jurrado J, LaVelle M, Newmark A,Takayama H, Sonett JR, Bacchetta M: Subclavian artery cannulation forvenoarterial extracorporeal membrane oxygenation.
8. Abrams D, Brenner K, Burkart KM, Agerstrand C, Thomashow B, Bacchetta M,Brodie D: Pilot study of extracorporeal carbon dioxide removal tofacilitate extubation and ambulation in COPD exacerbations. Ann AmThorac Soc 2013, 10:307–