An Interprofessional Approach to Mobilizing Patients With COVID-19 Receiving Extracorporeal Membrane Oxygenation

摘要

Objective: To assess survival outcomes with the intervention of an interprofessional mobilization program for patients with COVID-19 who were receiving venovenous extracorporeal membrane oxygenation (VV-ECMO). Design: Preintervention and postintervention retrospective cohort study. Methods: Survival outcomes of nonmobilized, adult patients (n = 16) with COVID-19 who were receiving VV-ECMO (May 2020 through December 2020) were compared with those of 26 patients who received a mobility care plan (January 2021 through November 2021). In the preintervention group, full sedation and paralysis were used. In the postintervention group, an early mobilization strategy involving interprofessional collaboration was introduced. Results The postintervention group had improved survival (73.1% vs 43.8%; P <.04); fewer days of receiving paralytics, fentanyl, and midazolam (P<.01 for all); but more days of dexmedetomidine, morphine, and ketamine administration (P <.01 for all). Concomitantly, more patients in the postintervention cohort received oral or transdermal analgesics, oral anxiolytics, and oral antipsychotics (P <.01 for all), and also required more VV-ECMO cannula adjustments (P =.03). Conclusion: Early mobilization of patients with COVID-19 who were receiving VV-ECMO improved survival rates but led to more cannula adjustments.