Abstract P-113: MOBILISATION IN CHILDREN ON EXTRACORPOREAL MEMBRANE OXYGENATION: A LITERATURE REVIEW

Abstract

Aims & Objectives: Extracorporeal membrane oxygenation (ECMO) in the critical care setting has been associated with immobilisation-related complications and morbidities because bed rest has been the standard of care for patients on ECMO. Several recent articles have discussed the feasibility and safety of providing physiotherapy interventions, including mobilisation for patients with invasive lines, tubes, monitors, and cardiac support devices. These studies have shown that mobilisation can be safe and effective, despite high illness acuity. This literature review aims to examine the research evidence of the feasibility and types of mobilisation for children on ECMO. Methods Research studies conducted between 2012 and 2017 were identified using PubMed, CINHAL, MEDLINE, Google Scholar and the Cochrane Database of Systematic Reviews databases using the search terms “extracorporeal membrane oxygenation”, “intensive care”, “paediatric”, “children”, “physiotherapy” and “mobilisation”. Results Seven articles met the inclusion criteria. All articles were case studies and included a total of 11 children aged from 4 to 17 years. Almost all cases reported the use of portable ECMO circuits. Conclusions The case reports demonstrated that coordinated, interdisciplinary team effort can be safely used to ambulate paediatric patients on ECMO. However, careful patient selection is necessary for success and to prevent adverse events. Further research is needed to examine and determine patient selection criteria for mobilising paediatric patients on ECMO. Current evidence is limited to case studies, hence future research should include randomised controlled trials to understand true effectiveness of mobilisation for this population.