Safety of Chest Physiotherapy for Acute Respiratory Distress Syndrome during Venovenous Extracorporeal Membrane Oxygenation: A Case Report

Abstract

Background and Purpose: In this case report, we evaluated safety of chest physiotherapy (CPT) for an adult patient with acute respiratory distress syndrome (ARDS) during venovenous extracorporeal membrane oxygenation (VV ECMO). Methods: CPT consisted of chest wall mobilization, positioning, ventilator hyperinflation and suctioning. The parameters used to evaluate safety of CPT while the case was on VV ECMO included occurrences of adverse events (i.e., arrhythmia, ventricular tachycardia, cardiac arrest, bleeding, and removal of endotracheal tube or unplanned decannulation) and vital sign changes. Results: The reported case received a total of six CPT sessions with no adverse events occurred. The greatest magnitude of systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate and oxygen saturation changes (post-pre CPT) were 6 mmHg, 4 mmHg, 5 bpm, 4 breaths/min, and 3%, respectively. Conclusion: In this case report we demonstrated that routine CPT is safe for patient with VV ECMO. CPT helped to achieve optimal airway hygiene and facilitated cough function recovery in this case. Future research with larger sample size is needed to confirm the safety of CPT in patients with VV ECMO and further investigation to assess the impact of CPT on patient recovery after weaning from VV ECMO support is warranted. Clinical Relevance: There was no significant adverse event in this case. We believe it is safe and feasible to perform CPT for patient during VV ECMO.