Title: The Role of Occupational Therapy in Patients Requiring Extracorporeal Membrane Oxygenation with Coronavirus Disease: A Pilot Case Series

Authors:
Lydia Sura MOT, OTR/L
Jenna Hightower PT, DPT, CCS
Jennifer Birst, OT
Olivia Davis, MOT, OTD, OTR/L
Pablo Moreno Franco, MD
Pramod Guru, MBBS, MD
Gregory Worsowicz, MD
Nikki Matos, APRN, DNP
Devang Sanghavi, MD

JACOT Volume 4, Issue 1

Abstract

The purpose of this study is to describe the occupational therapy (OT) course and functional outcomes in critically ill patients requiring mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) with coronavirus (COVID-19). This is a retrospective case series from a quaternary care hospital for patients with confirmed COVID-19 from April 2020 to July 2021. Patients were included in the study if they were admitted to the intensive care unit (ICU) on MV, on ECMO, and had OT during their hospitalization. The Activity Measure for Post-Acute Care (AM-PAC) “6-Clicks” was utilized to track each patient’s functional progress throughout their hospitalization. A total of 11 (n = 11) patients that met study criteria were included in the series. A total of 5 (n = 5, 45%) patients were seen while on ECMO, whereas the remainder (n = 6, 54%) were treated post-ECMO decannulation. The ECMO group had OT initiated earlier in the hospitalization than the post-ECMO group at 13.2 days versus 23.1 days, respectively. AM-PAC scores improved in the ECMO group by 40.41% and post-ECMO group by 23.75%. Patients who received OT for COVID-19 while on ECMO made substantial gains in their functional status by discharge compared to those who received OT only after decannulation. There were no adverse events in this case series. Future research should explore the impact of OT on functional and cognitive outcomes for this critically ill and unique patient population.