Yuan You, Zhang Jingwen, Mou Yanyan, Zhou Yan, Yang Chaojin, Li Li, Gao Huiming, Su De, Yan Feiyu, Hu Rujun
Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, P.R. China.
School of Nursing, Zunyi Medical University, Zunyi, Guizhou Province, P.R. China.
Medicine (Baltimore). 2025 Aug 22;104(34):e44008. doi: 10.1097/MD.0000000000044008.
The long-term complications of extracorporeal membrane oxygenation (ECMO) have not been well documented, especially the rare lower extremity drop foot (LEDF). Understanding the mechanisms and management of such complications is critical to improving patient outcomes. What is the role of patient-based on user portrait and health management journey map (HMJM) for rehabilitation management of patients with post-intensive care syndrome (PICS)?
We reported a case of a patient who developed LEDF after receiving ECMO for severe heart failure. The patient's user profile revealed a 17-year-old female athlete with a past history of hypertension. After treatment with ECMO, the patient developed LEDF with loss of sensation and motor deficits resulting in third-degree burns, which were inadvertently caused by using an electric stove for heating in the winter. During her hospitalization, she experienced several medical interventions and became more sensitive to pain and dysfunction perception. After discharge from the ICU, the patient reported significant difficulties in mobility, quality of life, and mental health.
The diagnosis of LEDF was confirmed by clinical electromyography, third-degree burns were assessed using the burn assessment criteria, and the scale confirmed PICS.
User portrait and HMJM provided patients with personalized integrated rehabilitation care from a multidisciplinary team. This included physical and pharmacological treatment for foot drop. A skin graft was applied to the burned area. In addition, psychotherapy was received during the peri-rehabilitation period.
Despite comprehensive interventions, the patient showed only partial recovery of foot function and required long-term rehabilitation and assistive devices for daily activities. However, mental health performance was better than before.
This case highlighted the importance of monitoring patients with ECMO for neuromuscular injuries, such as LEDF. The need for early intervention to prevent secondary injuries, such as burns. It also demonstrated the value of user portrait and HMJM in guiding individualized rehabilitation care plans for PICS.
体外膜肺氧合（ECMO）的长期并发症尚未得到充分记录，尤其是罕见的下肢垂足（LEDF）。了解此类并发症的机制和管理对于改善患者预后至关重要。基于用户画像和健康管理旅程地图（HMJM）的患者在重症监护后综合征（PICS）患者康复管理中的作用是什么？
我们报告了一例因严重心力衰竭接受ECMO治疗后出现LEDF的患者。患者的用户资料显示为一名17岁的女性运动员，既往有高血压病史。接受ECMO治疗后，患者出现LEDF，伴有感觉丧失和运动功能障碍，导致三度烧伤，这是在冬季使用电炉取暖时意外造成的。住院期间，她接受了多次医疗干预，对疼痛和功能障碍感知变得更加敏感。从重症监护病房出院后，患者报告在行动能力、生活质量和心理健康方面存在重大困难。
通过临床肌电图确诊为LEDF，使用烧伤评估标准评估三度烧伤，并通过量表确诊为PICS。
用户画像和HMJM为患者提供了来自多学科团队的个性化综合康复护理。这包括针对足下垂的物理和药物治疗。对烧伤部位进行了植皮。此外，在康复前期接受了心理治疗。
尽管进行了全面干预，患者的足部功能仅部分恢复，日常生活需要长期康复和辅助设备。然而，心理健康状况比以前有所改善。
该病例强调了监测接受ECMO治疗患者神经肌肉损伤（如LEDF）的重要性。需要早期干预以预防继发性损伤，如烧伤。它还展示了用户画像和HMJM在指导PICS个体化康复护理计划方面的价值。
