Use of Structured Exercise Program With Resistance Training for Veno-Venous Extracorporeal Membrane Oxygenation After Lung Transplantation: A Case Report

PURPOSE: Extracorporeal membrane oxygenation (ECMO) is crucial in the management of severe cardiopulmonary dysfunction. Although early rehabilitation in the intensive care unit (ICU) has been shown to reduce ICU-acquired weakness and improve patient outcomes, there is limited evidence on structured rehabilitation programs for patients on veno-venous ECMO (VV-ECMO) for the treatment and management of their disease process. METHODS: Herein, a case of a multidisciplinary progressive rehabilitation program with a focus on resistance training that enhanced functional improvement in a patient on VV-ECMO after lung transplantation is reported. RESULTS: A female in her sixties with a history of idiopathic pulmonary fibrosis underwent lung transplantation but subsequently developed acute respiratory distress syndrome requiring VV-ECMO on postoperative day 13. A high-intensity rehabilitation protocol, which included ambulation, passive through active range of motion exercises, physical/occupational therapy, and resistance training, was implemented on postoperative day 16. The patient demonstrated progressive improvement in exercise tolerance, resistance training duration, gait distance, and functional strength. CONCLUSIONS: This case highlights the potential benefits of high-intensity rehabilitation to enhance physical function and mobility in patients on VV-ECMO. Further research is warranted to evaluate the effectiveness of the high-intensive rehabilitation and to establish standardized rehabilitation protocols in VV-ECMO settings.