Background: The use of extracorporeal membrane oxygenation (ECMO) has increased significantly to support cardio-respiratory failure patients. The ECMO utilization has worsened immobility for the critically ill patients.
Objective: To evaluate the evidence for the effects of early mobilization in cardiothoracic surgery patients receiving ECMO on feasibility and safety, duration of ECMO utilization as well as ICU and hospital length of stay.
Methods: Using a combination of MeSH terms: “early mobilization” and “ECMO”, Medline: Ovid, Embase, Scopus and CINAHL databases were searched. Studies were evaluated to determine fit to the inclusion criteria. Considering the limited amount of high quality evidence found, the inclusion criteria were expanded to include studies evaluating sedation interruption, extubation and early mobilization in intensive care unit patients with/without ECMO.
Results: Eighteen studies were selected. The quality of the selected studies was assessed using the GRADE system. All the included studies reported on a multidisciplinary team implementing early mobilization which was feasible and safe in patients receiving ECMO. One study reported on reducing the duration of ECMO, two studies reported reducing ICU and hospital length of stay and reducing ICU and hospital mortality among ECMO patients receiving early mobilization.
Conclusions: An experienced, multidisciplinary team undertaking early mobilization seems feasible and safe. Early mobilization is beneficial in reducing critical care associated complications as well as reduces ICU and hospital length of stay in patients receiving ECMO.
VV ECMO VA ECMO Early mobilization Cardiothoracic surgery Post intensive care syndrome
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