Transplantation |

Improved Recovery Time After Active Rehabilitation During ECMO as a Bridge to Lung Transplantation FREE TO VIEW

Kyle Rehder*, MD; David Turner, MD; Mathhew Hartwig, MD; W. Williford, RRT; Robert Rudder, RRT; Desiree Bonadonna, CCP; Richard Walczak, CCP; R. Davis, MD; David Zaas, MD; Ira Cheifetz, MD
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Duke Children's Hospital, Durham, NC

Chest. 2012;142(4_MeetingAbstracts):1098A. doi:10.1378/chest.1384194
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SESSION TYPE: Lung Transplantation Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Patients with end-stage lung disease may often progress to critical illness, which dramatically reduces their chance of survival following lung transplantation. Pre-transplant deconditioning has a significant impact on outcomes for all lung transplant patients and is likely a major contributor to the increased mortality in critically ill lung transplant recipients. The aim of this study is to investigate the effect of active rehabilitation while on extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation.

METHODS: All patients bridged to lung transplantation with ECMO at our center were retrospectively reviewed. Two cohorts were compared: those who underwent active rehabilitation while on ECMO pre-transplant, and those who did not.

RESULTS: Eight patients were identified for inclusion. One year survival for all patients was 100%. Patients participating in pre-transplant rehabilitation had shorter post-transplant length of mechanical ventilation (3 days vs. 34 days, p=0.02), ICU stay (11 days vs. 45 days, p=0.02), tracheostomy time (24 days vs. 73 days, p=0.03), and hospital stay (28 days vs. 80 days, p=0.02). No patients who participated in active rehabilitation had post-transplant myopathy, compared to three of four patients who did not participate in pre-transplant rehabilitation on ECMO.

CONCLUSIONS: Bridging critically ill patients to transplant with ECMO is a viable treatment option, and active participation in physical therapy, including ambulation, provides a more rapid post-transplantation recovery.

CLINICAL IMPLICATIONS: This study has the potential to impact care of critically ill pre-lung transplant patients as well as all patients receiving ECMO.

DISCLOSURE: The following authors have nothing to disclose: Kyle Rehder, David Turner, Mathhew Hartwig, W. Williford, Robert Rudder, Desiree Bonadonna, Richard Walczak, R. Davis, David Zaas, Ira Cheifetz

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Duke Children's Hospital, Durham, NC




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