Physical Rehabilitation and Mobilization in Patients Receiving Extracorporeal Life Support: A Systematic Review.

OBJECTIVES: We planned to synthesize evidence examining the potential efficacy and safety of performing physical rehabilitation and/or mobilization (PR&M) in adult patients receiving extracorporeal life support (ECLS). DATA SOURCES: We included any study that compared PR&M to no PR&M or among different PR&M strategies in adult patients receiving any ECLS for any indication and any cannulation. We searched seven electronic databases with no language limitations. STUDY SELECTION AND DATA EXTRACTION: Two reviewers, independently and in duplicate, screened all citations for eligibility. We used the Cochrane Risk of Bias 2 and Cochrane Risk Of Bias In Non-randomized Studies of Interventions tools to assess individual study risk of bias. Although we had planned for meta-analysis, this was not possible due to insufficient data, so we used narrative and tabular data summaries for presenting results. We assessed the overall certainty of the evidence for each outcome using the Grading of Recommendations Assessment, Development, and Evaluation framework. DATA SYNTHESIS: We included 17 studies that enrolled 996 patients. Most studies examined venovenous extracorporeal membrane oxygenation (ECMO) and/or venoarterial ECMO as a bridge to recovery in the ICU. We found an uncertain effect of high-intensity/active PR&M on mortality, duration of mechanical ventilation, ICU length of stay, hospital length of stay, or quality of life compared with low-intensity/passive PR&M in patients receiving ECLS (very low certainty due to very serious imprecision). There was similarly an uncertain effect on safety events including clinically important bleeding, spontaneous intracerebral hemorrhage, limb ischemia, accidental decannulation, or ECLS circuit dysfunction (very low certainty due to very serious risk of bias and imprecision). CONCLUSIONS: Based on the currently available summary of evidence, there is an uncertain effect of high-intensity/active PR&M on patient important outcomes or safety in patients receiving ECLS. Despite indirect data from other populations suggesting potential benefit of high-intensity PR&M in the ICU; further high-quality randomized trials evaluating the benefits and risks of physical therapy and/or mobilization in this population are needed.

The correlation between altmetric score and traditional measures of article impact for studies published within the Surgeon Journal.

Alternative metrics, or altmetrics, have emerged as a promising tool for measuring the social impact of research, which is increasingly important in today's digital and social media-driven world. Altmetric Attention Score (AAS) is a weighted count of all the online attention garnered by a study, and it is currently unclear whether a relationship with traditional bibliometrics exists. The purpose of this article was to retrospectively review articles published in the Surgeon Journal from 2003 to 2020 to compare AAS with bibliometric parameters using an Independent t-test and Pearson's correlation analysis. There were statistically significant weakly positive relationships between AAS and sample size, number of reads, and number of citations. There was no statistically significant relationship between AAS and number of authors, H-index, or level of evidence. This study highlights the potential value of altmetrics by measuring the social impact of research as altmetrics can provide valuable information not captured by traditional metrics. It is currently unclear what the optimal balance of social and academic impact is in evaluating research impact and how altmetrics can be integrated into existing research frameworks.