Abstract

Many cardiac, pulmonary, and psychiatric complications occur due to long-term bed rest, infection, and critical illness neuropathy/myopathy in extra-corporeal membrane oxygenation (ECMO) applied coronavirus disease-2019 (COVID-19) inpatients in intensive care units. Physiotherapy plays an important role in restoring physical functions in the subacute phase following ECMO decannulation. After being discharged, and with combined rehabilitation, these patients experience a faster recovery and their quality of life increases. In this article, the effects of the combined physiotherapy program, which was applied to two patients with COVID-19 who received ECMO treatment and were discharged from the intensive care unit, is discussed. Early application of the combined rehabilitation program after discharge resulted in a positive outcome.

Keywords: COVID-19, early rehabilitation, extra-corporeal membrane oxygenation

References

  1. Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators, Davies A, Jones D, Bailey M, Beca J, Bellomo R, Blackwell N, et al. Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA 2009;302:1888-95.
  2. Noah MA, Peek GJ, Finney SJ, Griffiths MJ, Harrison DA, Grieve R, et al. Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A(H1N1). JAMA 2011;306:1659-68.
  3. Shekar K, Badulak J, Peek G, Boeken U, Dalton HJ, Arora L, et al. Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers. ASAIO J 2020;66:707-21.
  4. Sheehy LM. Considerations for Postacute Rehabilitation for Survivors of COVID-19. JMIR Public Health Surveill 2020;6:e19462.
  5. Zhu C, Wu Y, Liu H, Ban Y, Ma X, Zhang Z. Early pulmonary rehabilitation for SARS-CoV-2 pneumonia: Experience from an intensive care unit outside of the Hubei province in China. Heart Lung 2020;49:449-50.
  6. Mao L, Luo L, Wang D, Yu Y, Dong S, Zhang P, et al. Early rehabilitation after lung transplantation with extracorporeal membrane oxygenation (ECMO) of COVID-19 patient: a case report. Ann Transl Med 2021;9:512.
  7. El Naggar TE, Obaya HE, Ismail AF, Azzam RE, El Naggar AE. Inspiratory Muscle Training Prevents Diaphragmatic Atrophy in Mechanically Ventilated COVID-19 Patients. IJMA 2021;3:1761-71.
  8. Siddiq MAB, Rathore FA, Clegg D, Rasker JJ. Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic. Turk J Phys Med Rehabil 2020;66:480-94.
  9. Udina C, Ars J, Morandi A, Vilaró J, Cáceres C, Inzitari M. Rehabilitation in adult post-COVID-19 patients in post-acute care with Therapeutic Exercise. J Frailty Aging 2021;10:297-300.
  10. Gautam AP, Arena R, Dixit S, Borghi-Silva A. Pulmonary rehabilitation in COVID-19 pandemic era: The need for a revised approach. Respirology 2020;25:1320-2.
  11. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999;54:581-6.
  12. Simonelli C, Paneroni M, Vitacca M, Ambrosino N. Measures of physical performance in COVID-19 patients: a mapping review. Pulmonology 2021;27:518-28.
  13. Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. Kısa Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilaç ve Tedavi dergisi 1999;12:102-6.
  14. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 2019;38:48-79.
  15. Abodonya AM, Abdelbasset WK, Awad EA, Elalfy IE, Salem HA, Elsayed SH. Inspiratory muscle training for recovered COVID-19 patients after weaning from mechanical ventilation: A pilot control clinical study. Medicine (Baltimore) 2021;100:e25339.
  16. Koukourikos K, Tsaloglidou A, Kourkouta L. Muscle atrophy in intensive care unit patients. Acta Inform Med 2014;22:406-10.
  17. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020;21:300-7.e2.
  18. Kakehi S, Wakabayashi H, Inuma H, Inose T, Shioya M, Aoyama Y, et al. Rehabilitation Nutrition and Exercise Therapy for Sarcopenia. World J Mens Health 2022;40:1-10.
  19. Polastri M, Swol J, Loforte A, Dell'Amore A. Extracorporeal membrane oxygenation and rehabilitation in patients with COVID-19: A scoping review. Artif Organs 2022;46:30-9.
  20. Morris K, Osman L. Physiotherapy on ECMO: Mobility and beyond, Qatar Medical Journal, 4th Annual ELSO-SWAC Conference Proceedings 2017:58.
  21. Daynes E, Gerlis C, Chaplin E, Gardiner N, Singh SJ. Early experiences of rehabilitation for individuals post-COVID to improve fatigue, breathlessness exercise capacity and cognition - A cohort study. Chron Respir Dis 2021;18:14799731211015691.

How to cite?

1.
Ertürk N, Küçük AO, Özdoğan M, Pehlivanlar Küçük M. Effectiveness of Early Combined Rehabilitation in COVID-19 Related ARDS Patients After the Successfull Application of Extracorporeal Membrane Oxygenation: Two Case Reports. Turk J Intensive Care. 2022;20(3):165-171. https://doi.org/10.4274/tybd.galenos.2022.05706