Unit of Intensive Care, Regional ECMO Referral Center, Careggi University Hospital, Florence, Italy -
Unit of Intensive Care, Regional ECMO Referral Center, Careggi University Hospital, Florence, Italy.
Minerva Anestesiol. 2019 Sep;85(9):989-994. doi: 10.23736/S0375-9393.19.13287-7. Epub 2019 Mar 12.
To date, there is no agreement on the timing to perform a physical session in patients on veno-venous extracorporeal membrane oxygenation (VV-ECMO). We aimed to assess whether early physiotherapy (within the first week from ECMO start) could affect in-ICU mortality.
Our retrospective observational study included 101 adults supported on VV ECMO from 2009 to 2016, consecutively admitted at our ECMO referral Center in Florence (Italy). Clinical data right before ECMO start were collected for all patients. The level of mobilization using the ICU mobility scale was recorded on the first session and at discharge.
Early physiotherapy (within the first week) was more frequently initiated in patients with lower BMI (P=0.013) and it was associated with lower duration of ECMO support (P=0.03), mechanical ventilation (P=0.001) and length of stay (P=0.001). In-ICU mortality was not different between the two subgroups.
In patients on VV-ECMO support, physiotherapy is feasible and safe and that early physiotherapy, initiated within the first week from ECMO start, is associated with shorter duration of ECMO support and ICU length of stay.
迄今为止，对于行静脉-静脉体外膜肺氧合（VV-ECMO）的患者何时进行物理治疗尚未达成共识。我们旨在评估早期物理治疗（在 ECMO 启动后的第一周内）是否会影响 ICU 死亡率。
我们的回顾性观察性研究纳入了 2009 年至 2016 年期间在意大利佛罗伦萨 ECMO 转诊中心连续收治的 101 例接受 VV-ECMO 支持的成年人。对所有患者在开始 ECMO 前采集临床数据。在第一次治疗和出院时记录 ICU 活动量表上的活动程度。
低 BMI 患者（P=0.013）更常进行早期物理治疗（在第一周内），并且与 ECMO 支持时间（P=0.03）、机械通气时间（P=0.001）和住院时间（P=0.001）较短有关。两组患者的 ICU 死亡率无差异。
在接受 VV-ECMO 支持的患者中，物理治疗是可行且安全的，并且在 ECMO 启动后的第一周内开始的早期物理治疗与 ECMO 支持时间和 ICU 住院时间较短有关。
