Extracorporeal Membrane Oxygenation (ECMO) treatment and physiotherapy of the patient with Acute Distress Syndrome (ARDS)

Ewa Godula, Dariusz Szurlej, Bartosz Szurlej

Ewa Godula, Dariusz Szurlej, Bartosz Szurlej – Extracorporeal Membrane Oxygenation (ECMO) treatment and physiotherapy of the patient with Acute Distress Syndrome (ARDS). Fizjoterapia Polska 2012; 12(4); 397-403

Abstract
Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition, requiring urgent medical intervention. Pneumonia, shock, sepsis, multiorgan trauma or other morbidities may cause an alveolar-capillary barrier failure, which leads to ARDS. Sometimes the etiology of ARDS is not fully known, what makes the treatment difficult. In some cases, the usage of conventional mechanical ventilation techniques may be insufficient. The patients may have a chance of survival through using Extracorporeal Membrane Oxygenation (ECMO). Although this procedure does not treat the pulmonary disease, it gives more times for the lungs to regenerate and the approach enables essential treatment and gives the physician an ability to find the factor causing acute respiratory failure. Nevertheless, the use of ECMO is not completely harmless to human body and entails the risk of numerous complications of which the most dangerous are bleeding into the body and bleeding from the cannulation areas. The team dealing with ECMO consists of a cardiac surgeon, an anesthesiologist and a perfusionist. Experience of the team and proper cooperation enables the treatment to be as effective as possible. Well selected and conducted rehabilitation is the element of the treatment, which reduces effects of a long-term hypokinesia, has a positive effect on a psychological area, and fast motor and respiratory mobilization can shorten the time of the treatment and reduce the costs of expensive therapy. The paper presents the case of a 19-year old woman with acute respiratory failure, who was qualified for veno-venous ECMO therapy and the authors’ own experiences in physiotherapy during the treatment.
Key words:
ECMO, respiratory failure, rehabilitation
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