Burns
The healing process for patients with large and severe burns is often extremely complex and timely.
Mobility is often delayed due to strict wound healing protocols and protection of graft sites. Patients also have limited activity tolerance due to severe pain with mobility as healing tissues are stretched and moved and shearing that often occurs with traditional bed mobility.
Additionally, patients can have orthostatic intolerance due to vasoplegia from prolonged immobility as well as large volume shifts due to inflammation and fluid imbalances that occur with severe and extensive burns.
The total lift bed offers upright standing and weight bearing activities while keeping the patient in the same linear plane which helps to prevent painful stretching to healing tissues.
This can also be beneficial in improving upright orthostatic intolerance as the angle of verticalization can be titrated directly to the patient’s tolerance multiple times per day without time consuming transfers and the multiple caregivers needed to transfer to a tilt table, which are traditionally used.
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ECMO Resources:
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von Stumm M, Bojes P, Kubik M, et al. (2016). Feasibility and safety of mobilization of patients with extracorporeal membrane oxygenation: a prospective cohort study. The Thoracic and Cardiovascular Surgeon, 64(S 01), OP73. https://doi.org/10.1055/s-0036-1571526
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Ferreira DDC, Marcolino MAZ, Macagnan FE, et al. (2019). Safety and potential benefits of physical therapy in adult patients on extracorporeal membrane oxygenation support: a systematic review. Revista Brasileira de Terapia Intensiva, 31, 227-239. https://doi.org/
10.5935/0103- 507X.20190017
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Abrams D, Javidfar J, Farrand E, et al.(2014). Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Critical Care, 18(1), R38. https://doi.org/10.1186/cc13746
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Rehder KJ, Turner DA, Hartwig MG, et al: Active rehabilitation during extracorporeal membrane oxygenation as a bridge to lung transplantation, J Resp Care, 58(8): 1291-1298, 2013. https://doi.org/10.4187/respcare.02155
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Lehr CJ, Zaas DW, Cheifetz IM, Turner DA: Ambulatory Extracorporeal membrane oxygenation as a bridge to lung transplantation, Chest, 147(5): 1213-1218, 2015. DOI: 10.1378/chest.14-1288
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Abrams D, Garan AR, Brodie D: Awake and fully mobile patients on cardiac extracorporeal life support, Ann Cardiothorac Surg, 8(1): 44-53, 2019. DI: 10.21037/acs.2018.08.03
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Ko J, Cho TH, Park YH, et al: Feasibility and safety of early physical therapy and active mobilization for patients on extracorporeal membrane oxygenation, J ASAIO, 61: 564-568, 2015. DOI: 10.1097/MAT.0000000000000239
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Wells CL, Forrester J, Vogel J, et al: Safety and feasibility of early physical therapy for patients n extracorporeal membrane oxygenator: Univerysity of Maryland Medical Center experience, Crit Care Med, 46: 53-59, 2018. DOE: 10.1097/CCM. 0000000000002770
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Pasrija C, Mackowick KM, Raithel M, et al: Ambulation with femoral arterial cannulation can be safely performed on venoarterial extracorporeal membrane oxygenation, Ann Thorac Surg, 107: 1389-1394, 2019. https://doi.org/10.1016/j.athoracsur.2018.10.48
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Hightower J, Sura L. (2022) A Patient Post COVID-19 on ECMO as a Bridge to a Lung Transplant and CABG: A Brief Case Report Using Progressive Tilt Therapy. Int J SPHM. Special Issue (Early Mobility):31-33. https://sphmjournal.com/wp-content/uploads/
April2022SpecialIssueEM.pdf
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Sura L, Hightower J, Birst J, et al. (2022). The role of occupational therapy in patients requiring extracorporeal membrane oxygenation with coronavirus disease: A pilot case series. J of Acute Care Occ Therapy, 4(1), 1-27. https://jacotorg.files.wordpress.com/2022/03/
jacot_volume-4_issue-1_winter2022_sura-et-al.pdf