Rationale and recommendations for occupational therapy and physiotherapy in positioning adults with acute respiratory failure connected to extracorporeal membrane oxygenation. A narrative review.
DOI:
https://doi.org/10.56294/sctconf20251553Keywords:
Extracorporeal Membrane Oxygenation, Occupational Therapy, Physical Therapy Specialty, Critical Care, Respiratory Insufficiency, Respiratory Distress SyndromeAbstract
Extracorporeal membrane oxygenation (ECMO) is a life support system that facilitates gas exchange in patients experiencing catastrophic respiratory failure. ECMO connection can last from a few days to several weeks, resulting in muscle atrophy, pathological changes in the lengths of both active and passive joint stabilising structures, and alterations in the alignment of body segments. These dysfunctions may be exacerbated if patients do not maintain proper positioning, which can delay rehabilitation. Therapeutic positioning (TP) is a fundamental tool in caring for patients hospitalised in the intensive care unit. Adequate TP application helps prevent immobility complications, promotes body alignment, and enhances the patient's functionality during recovery. From a biomechanical perspective, TP supports preserving essential musculoskeletal functions such as strength, joint mobility, and endurance, facilitating patient participation in meaningful activities. Its implementation should be based on biomechanical principles, personalised adaptations, and continuous monitoring to ensure effectiveness in rehabilitation. This review examines the rationale for TP in adults with acute respiratory failure on ECMO from occupational and physical therapy perspectives. Additionally, recommendations are provided to improve the application of this intervention, particularly in the increasingly common context of prone positioning in patients with ECMO.
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Copyright (c) 2025 Alejandra Hörmann-Labarthe , Sthefany Quezada-Hernández , Francisco Salinas-Barahona , Ruvistay Gutierrez-Arias (Author)
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