Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Naomi Kaplan, MBBS: No financial relationships or conflicts of interest
Objective : To determine early functional outcomes in patients who received extracorporeal membrane oxygenation (ECMO) during critical care.
Design: Retrospective cohort study.
Setting : The cardiothoracic intensive care unit (CTICU) of an American tertiary care teaching hospital.
Participants : All adult patients who received ECMO treatment in the CTICU and survived to discharge from the hospital, from January 1, 2019 to May 1, 2019.
Main Outcome Measures: Outcomes included discharge disposition and Functional Independence Measure (FIM) deficit at discharge. FIM deficit was calculated as the difference in FIM score from the maximum (best) FIM score of 7/7 x 3 = 21/21, over 3 activities of daily living (ADLs): bed mobility, sit-to-stand transfers, and gait. A clinically significant FIM deficit was considered >3, (i.e. cumulative FIM score of < 18/21).
Results: On average, 16 patients received ECMO for 9 days. Of the 16 patients, 4 (25%) were transferred on ECMO to another center as a bridge to transplant, 5 (31%) were discharged to acute rehabilitation and one to subacute rehabilitation. Almost 38% (6/16) were discharged home. All 16 patients had a clinically significant FIM deficit, with a median discharge FIM score of 12/21 (overall FIM deficit of 9). The overall FIM deficit for patients not discharged home was 11 (n=10; median FIM score 10/21).
Conclusions: Understanding and preventing long term functional deficits starts with quantifying short-term outcomes status post-ECMO in the acute period. Patients who are status post ECMO continue to have significant functional deficits at hospital discharge regardless of disposition. This study supports allocation of physical therapy resources to this patient population, as well as post-acute therapy resources, and long-term multidisciplinary follow-up, including a role for physiatric care.
Level of Evidence: Level III
To cite this abstract in AMA style:Kaplan N, Maltser S. Functional Outcomes in Intensive Care Patients Treated with Extracorporeal Membrane Oxygenation [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/functional-outcomes-in-intensive-care-patients-treated-with-extracorporeal-membrane-oxygenation/. Accessed April 16, 2021.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/functional-outcomes-in-intensive-care-patients-treated-with-extracorporeal-membrane-oxygenation/