PATIENT STORY: ECMO*-PATIENT
In cooperation with the BGU Murnau
Background
In early November 2021, the patient – a 53-year-old healthy man with a sporting background – contracted the coronavirus and rapidly developed COVID-19 pneumonia with a severe course.
Course of the disease
By the end of November 2021, due to a deterioration in his respiratory condition, intubation and mechanical ventilation became necessary. The lungs were so severely damaged that respiratory failure occurred, requiring ECMO therapy. Therefore, in early December 2021, the patient was transferred to the intensive care center of the BGU Murnau.
Use of robot-assisted mobilization
(since beginning of December 2021)
The severity and the duration of the illness caused the patient to lose a large amount of his muscle mass, resulting in a significant ICU-Acquired Weakness (ICUAW). This means that the patient could no longer move himself, neither legs nor arms and hands. In this condition, mobilization with the support of the VEMOTION system began at the end of December. The therapy was conducted daily for about 30 minutes, with the patient reaching a total of approximately 1000 steps per session. After just a short period of time, lung function stabilized, and the patient was able to be weaned off ECMO at the beginning of January 2022. The ICUAW receded so that the patient was able to attempt to stand at bed side for the first time.
Under such circumstances with mechanical ventilation and ECMO therapy, conventional mobilization is only possible with an extremely high effort of personnel. With the use of the VEMOTION robot, patients can be offered excellent mobilization in a very early phase of rehabilitation. This is particularly important with regard to the long-term success of treatment and the further rehabilitation process.
Outcome
(beginning of January 2022)
The ECMO therapy was ended at the beginning of January 2022. With clinical improvement of the polyneuromyopathy with increased muscle strength values of 3-4/5 (MRC scale), progress was achieved in discontinuous weaning and mobilization up to the walker. The tracheostomy tube was removed in mid-January 2022. Just one day later, the patient was transferred to the normal ward, and another three days later he was discharged home with oxygen insufflation therapy still in place. Prompt COVID-specific rehabilitation therapy was planned; under these rehabilitative measures, the patient initially achieved freedom from oxygen at rest and, six months after the onset of the illness, can now cope with light physical stress again without additional oxygen. The patient, his family, and the entire intensive care unit team were relieved by the progress of recovery.
Goals
Stabilization of the blood circulation, promotion of self-activity, increase in vigilance, mobilization of joints, counteracting secondary consequences of illness, shortening of ICU stay.
Thank you for your cooperation!
The BGU Murnau relies on a robotic assistance system with artificial intelligence to enable the implementation of early mobilization therapies for severely affected patients already in the intensive care unit. Since September 2020, the VEMOTION system with a total of five intensive care beds is in use at the BGU Murnau. This allows critically ill patients, including ventilated patients, to be mobilized individually and safely.
*ECMO stands for extracorporeal membrane oxygenation = lung replacement procedure