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Extracorporeal membrane oxygenation and rehabilitation in patients with COVID-19: A scoping review.
Polastri, Massimiliano; Swol, Justyna; Loforte, Antonio; Dell'Amore, Andrea.
  • Polastri M; Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St. Orsola University Hospital, Bologna, Italy.
  • Swol J; Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University General Hospital, Nuremberg, Germany.
  • Loforte A; Department of Cardiac, Thoracic, Vascular Diseases, Cardiac Surgery and Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St. Orsola University Hospital, Bologna, Italy.
  • Dell'Amore A; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Division of Thoracic Surgery, University of Padua, Padua, Italy.
Artif Organs ; 46(1): 30-39, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1517998
ABSTRACT
BACKGROUND AND

PURPOSE:

The coronavirus diseases 2019 (COVID-19) pandemic posed severe difficulties in managing critically ill patients in hospital care settings. Extracorporeal membrane oxygenation (ECMO) support has been proven to be lifesaving support during the SARS-CoV-2 outbreak. The purpose of this review was to describe the rehabilitative treatments provided to patients undergoing ECMO support during the COVID-19 pandemic.

METHODS:

We searched PubMed and Scopus for English-language studies published from the databases' inception until June 30, 2021. We excluded editorials, letters to the editor, and studies that did not describe rehabilitative procedures during ECMO support. We also excluded those articles not written in English.

RESULTS:

A total of 50 articles were identified. We ultimately included nine studies, seven of which were case reports. Only two studies had more than one patient; an observational design analyzing the clinical course of 19 patients and a case series of three patients. Extracorporeal support duration varied from 9 to 49 days, and the primary indication was acute respiratory distress syndrome COVID-19-related. Rehabilitative treatment mainly consisted of in-bed mobilization, postural transfers (including sitting), and respiratory exercises. After hospital discharge, patients were referred to rehabilitation facilities. Physiotherapeutic interventions provided during ECMO support and after its discontinuation were feasible and safe.

CONCLUSION:

The physiotherapeutic treatment of patients undergoing ECMO support includes several components and must be provided in a multidisciplinary context. The optimal approach depends on the patient's status, including sedation, level of consciousness, ECMO configuration, types of cannulas, and cannulation site.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: Artif Organs Year: 2022 Document Type: Article Affiliation country: Aor.14110

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: Artif Organs Year: 2022 Document Type: Article Affiliation country: Aor.14110