Ambulation Protocol for Adult Patients Receiving Extracorporeal Membrane Oxygenation: A Quality Improvement Initiative

The authors aimed to explore the applicability of the benefits of early mobility and ambulation for patients receiving extracorporeal membrane oxygenation (ECMO). This single-center preintervention, post-intervention review, performed at a high-volume center found that 13 out of 46 (28 percent) patients who met safety criteria ambulated from January through March 2021, compared to 14 out of 147 (10 percent) in historical controls. The authors note important considerations for devising similar protocols given the limited evidence available to date. Strategies employed by the interprofessional team included mobility discussions during rounds, the development of an ambulation safety checklist, clear expectations for providers during ambulation, and documentation to evaluate tolerance. Through standardized assessment and protocol intervention, progressive ambulation can be safely offered to some patients receiving ECMO.