Exercise Rehabilitation in Patients With Severe Cardiopulmonary Dysfunction on Extracorporeal Life Support

Launched by INSTITUTE FOR EXTRACORPOREAL LIFE SUPPORT · Jan 21, 2025

Keywords

ClinConnect Summary

I.Introduction

The long-term consequences of severe cardiac and/or lung dysfunction include: the increased use of sedation, increased parameters on the ventilator, and incidence of delirium. These sequelae are all associated with prolonged bed rest and immobility, which causes severe loss of muscle mass and bone density. Significant loss of muscle and bone causes patients to be at risk for muscle weakness, osteoporosis, and lowered endurance. Extracorporeal membrane oxygenation (ECMO) is a strategy used to mitigate severe cardiac and/or lung dysfunction. Briefly, during ECMO, blood passes ...

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Eligibility criteria

• • Inclusion Criteria--
• • 1. Age \>or equal to 18 years old
• • 2. On ECMO (VV and/or VA) for cardiopulmonary dysfunction/failure
• • 3. Admitted to Lung Recovery Intensive Care Unit (LRICU) or Cardiovascular Intensive Care Unit (CVICU).
• • 4. Richmond Agitation and Sedation Scale (RASS) greater than or equal to a score of -2 or greater.
• • Exclusion Criteria--
• • 1. Hemodynamically unstable as determined by clinical care team (including but not limited to: oxygen saturation \<90%, below target range of mean arterial pressure despite vasoactive or mechanical support, prone positioning, use of mechanical assist device (such as the intra-aortic balloon pump \[IABP\] or ventricular assist device \[VAD\]), active management of intracranial hypertension with abnormal intracranial pressure, spinal precautions, uncontrolled seizures, unstable major fracture, large open surgical wound, known controlled active bleeding).
• • 2. Unable to utilize the VitalGo Total Lift BedTM (TLB, Catalog No. V5, Miramar FL) (e.g., height restrictions \[\>228 cm\], weight restrictions \[\>425 lbs\])
• • 3. Pregnant or breast feeding.
• • 4. Anticipated transfer to another hospital within 72 hours.
• • 5. Not anticipated to survive more than 24 hours.
• • 6. Unable to obtain informed consent from either patient or legally authorized representative (LAR).
• • 7. Patients in the ICU but not on ECMO upon enrollment.
• • 8. Patients actively awaiting transplant (heart/lung) without potential for weaning from ECMO.