Active Rehabilitation in Patients Requiring Advanced Mechanical Circulatory Support and ECMO

Course overview

Rehabilitation therapy for patients requiring advanced mechanical circulatory support (MCS) and Extracorporeal Membrane Oxygenation (ECMO) is a rapidly growing area of practice for ICU physical and occupational therapists. In addition to progressing ICU and advanced support practice for both cardiac and pulmonary conditions, the COVID-19 pandemic has necessitated increased utilization and longer durations of ECMO support in patients with COVID-related respiratory failure. While safe mobilization of patients on MCS and ECMO support has been documented, evidence-based guidelines for MCS and ECMO rehabilitation remain sparse. The speaker will review relevant lab values, sedation considerations, and potential challenges that therapists may be faced with while working with this population and provide tools to advocate for improved mobility practice. Experiences will be shared regarding initiating a program, gaining physician and surgeon buy-in, up-training therapy staff, and progressing the program with support from all ICU teams including medical, nursing, respiratory therapy, perfusion, and rehabilitation therapy teams. Case studies will be reviewed and patient outcomes discussed to provide examples of rehabilitation interventions to progress beyond early mobility with lessons and considerations for PTs and OTs in all areas of practice.