Authors:
- Iva Marincel Antolović – Clinical Hospital Center Rijeka, Clinic for Anesthesiology, Intensive Care and Pain Management, Rijeka, Republic of Croatia
- Ivanka Baniček Šoša – Clinical Hospital Center Rijeka, Department of Physical and Rehabilitation Medicine, Rijeka, Republic of Croatia
- Martina Maričić Ljubas – Clinical Hospital Center Rijeka, Clinic for Anesthesiology, Intensive Care and Pain Management, Rijeka, Republic of Croatia
- Mia Hrlec – Clinical Hospital Center Rijeka, Clinic for Anesthesiology, Intensive Care and Pain Management, Rijeka, Republic of Croatia
- Matea Bagatin – Clinical Hospital Center Rijeka, Department of Physical and Rehabilitation Medicine, Rijeka, Republic of Croatia
- Marijan Mašić – Clinical Hospital Center Rijeka, Clinic for Anesthesiology, Intensive Care and Pain Management, Rijeka, Republic of Croatia
Article type:
Original Scientific Paper
Abstract:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a form of coronavirus which appeared in 2019 and causes coronavirus disease (COVID-19). The most severe form of COVID-19 disease and its complications are reasons why the patient is connected to invasive mechanical ventilation. Some patients develop an extremely severe clinical condition with acute respiratory and cardiac failure, and for these reasons are treated with extracorporeal membrane oxygenation (ECMO). ECMO is an out-of-body mechanical circulatory or respiratory support procedure that can be applied in two forms of support: venous-venous (V-V ECMO) modality which provides support in case of severe respiratory failure or venous-arterial (V-A ECMO) modality which provides respiratory and cardiovascular support to the patient.
Physiotherapy is an indispensable part in the treatment of patients with COVID-19 disease. The goal of physiotherapy is early rehabilitation and prevention of respiratory complications and complications of long-term immobilization. Physiotherapy in ICU is based on respiratory rehabilitation.
In this paper, we present the case of a 51-year-old with severe COVID-19 disease treated for the second time by invasive mechanical ventilation and extracorporeal membrane oxygenation. The patient was admitted to Clinical Hospital Center Rijeka at the Department of Intensive Care of COVID patients on May 17, 2021, intubated and connected to invasive mechanical ventilation, and on May 19, 2021, a V-V ECMO was placed. Throughout his stay, he was involved in physical therapy and rehabilitation. The patient was transferred to the Department of Physical Medicine and Rehabilitation on June 7, 2021, with the support of oxygen, in poor general condition, with an intense disorder of balance, coordination, and fine motor skills of the right hand. On June 19, 2021, the patient was discharged from the hospital completely independent in all aspects of daily life and without oxygen support.
Keywords:
COVID-19, ECMO, physical therapy, rehabilitation