Abstract 14879: Stroll in Style: Rocking the MCS Catwalk!

Abstract

Introduction: Patients who present with cardiogenic shock may require temporary mechanical circulatory support (tMCS) devices in the ICU. Hypothesis: Physical therapy (PT) and rehabilitation is associated with improved outcomes. But literature investigating the feasibility and safety of mobilization in patients on tMCS is limited. Methods: In this survey-based study, we examined various practice patterns in ambulating patients supported on tMCS globally. We received 93 responses of which 73 (80.22%) were from United States. Results: 82 programs believed that mobilization improved outcomes in these patients. Of these 81 programs (87.1%) ambulate patients supported on tMCS, but only 61 programs (65.59%) have an MCS trained physical therapist ambulating patients on tMCS. 72 programs (77.42%) reported staffing issues as a limiting factor in mobilizing these patients. (Figure 1) 82 programs (88.17%) would change the cannulation site for more convenient patient mobilization. 59 (63.44%) programs reported complications associated with mobilization which included device/cannula dislodgement, pump malfunction, bleeding, hemolysis, etc. (Figure 2) Only 41 programs (44.1%) have a guideline or protocol to ambulate these patients. Conclusions: We conclude that current state of PT in patients on tMCS is suboptimal and needs a uniform standardized protocol. Most programs need an experienced physical therapist to facilitate mobilization of these patients. We also outlined various patient and device related factors which can improve mobilization and outcomes in these patients. More studies are needed to assess impact of mobilization on outcomes and length of stay.