Early physiotherapy in the clinical course of patients on Veno-Venous Extracorporeal Membrane Oxygenation.

Aim: To examine the feasibility and safety of mobilizing patients while on VV ECMO support and to assess whether early physiotherapy (first session within the first week from ECMO start) could affect in-ICU mortality in adults supported on VV ECMO from 2009 to 2016, consecutively admitted to our ECMO referral Center Methods: Clinical data right before ECMO start were collected for all patients. The level of mobilization using the ICU mobility scale was recorded on the first session and at discharge. Results: In our series, 101 patients (101/160, 63.1%) were submitted to physiotherapy which was an independent predictor for in-ICU mortality (together with BMI). Among these patients, physiotherapy was started earlier in survivors when compared to not survivors (p=0.002). Early physiotherapy (within the first week) was more frequently initiated in patients with lower BMI (p=0.013) and it was associated with lower duration of ECMO support (p=0.03), mechanical ventilation (p=0.001) and length of stay (p=0.001). In-ICU mortality was significantly lower in patients who initiated physiotherapy within the first week since ECMO start (p=0.03). Conclusions: In patients on VV-ECMO support, physiotherapy is feasible and safe in the majority of patients and it is independently associated with in-ICU mortality. Early physiotherapy, initiated within the first week from ECMO start, is associated with shorter duration of ECMO support and ICU length of stay.