ABSTRACT
Background: Venovenous extracorporeal membrane oxygenation (VV ECMO) has shown to be beneficial for the treatment of severe COVID-19. Barriers to mobilization include acuity, devices, personal protective equipment, negative pressure rooms, and healthcare worker safety. We report our experience with progressive mobility in this complex patient population. Methods: A retrospective review of adult patients requiring VV ECMO for COVID-19 was performed at a single institution from April to July 2020. A multidisciplinary team collaborated daily to determine readiness for progressive mobility. Therapy interventions followed a five-stage protocol and were evaluated using three standardized functional mobility tools (Table 1). Scores were recorded at baseline, highest during ECMO run, and at discharge. Results: Seventeen of 28 COVID-19 patients received protocolized progressive mobility during their extracorporeal support period. The mean scores of the three mobility tools demonstrated an improvement over the course of hospitalization (Table 1). At the time of data analysis, one patient had expired and four patients were still on ECMO support. Twelve (71%) were weaned from ECMO and all were alive at discharge. Of the 12 discharged patients, 6 (50%) were discharged home or inpatient rehab, 4 (33%) to long-term acute care facility and 2 (17%) to their referring hospitals. There were no adverse events or circuit complications. No health care worker infection occurred. Discussion: Early and progressive mobility with a multidisciplinary team is safe and feasible in patients with COVID-19 supported by VV ECMO and may contribute to a high rate of weaning from extracorporeal support and survival to discharge.