Ann Rehabil Med.
2023 Jun;47(3):173-181. 10.5535/arm.22153.
Impact of Extra-Corporeal Membrane Oxygenation and Blood Purification Therapy on Early Mobilization in the Intensive Care Unit: Retrospective Cohort Study
- Affiliations
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- 1Department of Rehabilitation Medicine, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- 2Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
- 3Department of Physical Therapy, School of Health Sciences, Toyohashi Sozo University, Toyohashi, Japan
- 4Department of Rehabilitation Medicine, Tosei General Hospital, Seto, Japan
- 5Department of Rehabilitation Medicine, National Hospital Organization, Shizuoka Medical Center, Shizuoka, Japan
- 6Department of Rehabilitation Medicine, Ichinomiyanishi Hospital, Ichinomiya, Japan
- 7Department of Rehabilitation, Toyohashi Municipal Hospital, Toyohashi, Japan
- 8Department of Rehabilitation Medicine, Kainan Hospital, Yatomi, Japan
- 9Department of Emergency Medicine, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- KMID: 2543414
- DOI: http://doi.org/10.5535/arm.22153
Abstract
Objective
To investigate the effect on early mobilization in patients undergoing extra-corporeal membrane oxygenation (ECMO) and acute blood purification therapy in the intensive care unit (ICU).
Methods
We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU, aged ≥18 years, and received mechanical ventilation for >48 hours were eligible. The analyzed were divided into two groups: ECMO/blood purification or control group. Clinical outcomes; time to first mobilization, number of total ICU rehabilitations, mean and highest ICU mobility scale (IMS); and daily barrier changes were also investigated.
Results
A total of 204 patients were included in the analysis, 43 in the ECMO/blood purification group and 161 in the control group. In comparison of clinical outcome, the ECMO/blood purification group had a significantly longer time to first mobilization: ECMO/blood purification group 6 vs. control group 4 (p=0.003), higher number of total ICU rehabilitations: 6 vs. 5 (p=0.042), lower mean: 0 vs. 1 (p=0.043) and highest IMS: 2 vs. 3 (p=0.039) during ICU stay. Circulatory factor were most frequently described as barriers to early mobilization on days 1 (51%), 2 (47%), and 3 (26%). On days 4 to 7, the most frequently described barrier was consciousness factors (21%, 16%, 19%, and 21%, respectively)
Conclusion
The results of this study comparing the ECMO/blood purification group and the untreated group in the ICU showed that the ECMO/blood purification group had significantly longer days to mobilization and significantly lower mean and highest IMS.
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