PHYSIOTHERAPY AND REHABILITATION IN PEDIATRIC INTENSIVE CARE PATIENTS WITH EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT: 2 CASE REPORTS

The aim of this study was to summarize and analyze the potential effects of physiotherapy and rehabilitation practices in pediatric patients hospitalized in the pediatric intensive care unit and receiving extracorporeal membrane oxygenation (ECMO) support. ECMO is a life-saving gold standard treatment modality for patients with severe cardiac, respiratory, or combined cardiorespiratory failure that has emerged in recent years. Intensive care unit-acquired weakness (ICU-AW) is a frequently encountered condition in critically ill patients on ECMO due to prolonged intensive care unit hospitalization. Therefore, functional capacity decreases and mortality rates increase due to this weakness. Early mobilization and physical therapy in critically ill patients on ECMO have been proven to be safe practices in bridging to both heart/lung transplantation and recovery. Early mobilization has also been proven to prevent weakness associated with intensive care unit stay, reduce delirium episodes, and reduce the length of stay on mechanical ventilator and consequently reduce the length of hospital stay. Therefore, it is of great importance that early mobilization in ECMO patients is prepared within an individualized program by a team specialized in this field. This study presents 2 patients aged 3 and 10 years with dilated cardiomyopathy who were hospitalized in the pediatric intensive care unit. Whereas boy patient underwent venoarterial ECMO for 150 days, girl patient underwent for 70 days and died at follow-up. 2 patients were admitted to early rehabilitation program by the rehabilitation team as soon as their condition was stable. No joint contracture and pressure sores occurred with the rehabilitation programme applied. The patients could be extubated three times each. In this study, our aim is to contribute to the current literature on physiotherapy and rehabilitation practices applied in two pediatric patients followed in ECMO.