Ko YoungJun, Cho Yang Hyun, Park Yun Hee, Lee Hyun, Suh Gee Young, Yang Jeong Hoon, Park Chi-Min, Jeon Kyeongman, Chung Chi Ryang
From the *Physical Therapy Part, Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Seoul, Republic of Korea; †Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; ‡Department of Physical and Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea; §Division of Pulmonary and Critical Care Medicine, Department of Medicine, ¶Department of Critical Care Medicine, ‖Department of Cardiology, #Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
ASAIO J. 2015 Sep-Oct;61(5):564-8. doi: 10.1097/MAT.0000000000000239.
Physical therapy (PT) and early mobilization for critically ill patients have been popularized to decrease the length of hospital stay and to improve the quality of life after discharge. We reviewed our experience of PT and active mobilization for patients on extracorporeal membrane oxygenation (ECMO) in terms of its technical feasibility and safety. Study endpoints were safety events during PT and PT interruptions due to unstable vital signs. Of the eight patients, one patient (12.5%) had venoarterial ECMO, seven patients (87.5%) had venovenous ECMO. Among total of 62 sessions including 31 sessions (50%) of passive range of motion and electrical muscle stimulation, 17 sessions (27.4%) were performed for patients who were sitting in bed or on the edge of bed, two sessions (3.2%) were for strengthening in sitting, 11 sessions (18%) were for standing or marching in place, one session (2%) was for walking. Eight sessions (13%) of sitting were supported with invasive mechanical ventilation. Three sessions (5%) were stopped due to tachycardia (n = 1) and tachypnea (n = 2). There was no clinically significant adverse event in patients. Thus, early PT and mobilization for patients on ECMO might be feasible and safe at an experienced ECMO center.
物理治疗（PT）和对危重症患者进行早期活动已得到推广，以缩短住院时间并提高出院后的生活质量。我们回顾了我们在体外膜肺氧合（ECMO）患者中进行PT和主动活动的经验，评估其技术可行性和安全性。研究终点为PT期间的安全事件以及因生命体征不稳定导致的PT中断情况。8例患者中，1例（12.5%）采用静脉-动脉ECMO，7例（87.5%）采用静脉-静脉ECMO。在总共62次治疗中，包括31次（50%）被动关节活动度训练和肌肉电刺激，其中17次（27.4%）是为坐在床上或床边的患者进行的，2次（3.2%）是为坐位强化训练，11次（18%）是为站立或原地踏步训练，1次（2%）是为步行训练。8次（13%）坐位训练时采用有创机械通气支持。3次（5%）治疗因心动过速（n = 1）和呼吸急促（n = 2）而停止。患者未发生具有临床意义的不良事件。因此，在经验丰富的ECMO中心，对接受ECMO治疗的患者进行早期PT和活动可能是可行且安全的。
