eISSN 2097-6046
ISSN 2096-7446
CN 10-1655/R
Responsible Institution：China Association for Science and Technology
Sponsor：Chinese Nursing Association
中华急危重症护理杂志

Chinese Journal of Emergency and Critical Care Nursing >

2026 , Vol. 7 >Issue 5: 616 - 622

DOI: https://doi.org/10.3761/j.issn.2096-7446.2026.05.017

Evidence Synthesis Research

The effect of early mobilization in adult patients with extracorporeal membrane oxygenation：a meta-analysis

  • ZHANG Tianyu ,
  • CHENG Lingling ,
  • CHENG Zhen ,
  • SHAO Weiying ,
  • SHI Aili
Expand
  • 1 School of Public Health and Nursing， Hangzhou Normal University， Hangzhou 311121， China
    2 Department of Emergency， Zhejiang Provincial People’s Hospital， Hangzhou 310014， China
    3 General Affairs Office， People’s Hospital of Quzhou，Quzhou， Zhejiang Province 324000， China
    4 Nursing Department， Tongde Hospital of Zhejiang Province， Hangzhou 310012， China

Received date: 2025-05-13

  Online published: 2026-04-28

Supported by

Zhejiang Province Health and Science Research Foundation Project(2025KY609)

Fold

Abstract

Objective This study aims to evaluate the effect of early mobilization in patients with extracorporeal membrane oxygenation（ECMO）. Methods The databases of CNKI，Wanfang，VIP，CBM，PubMed，Embase，Cochrane Library，and Web of Science were searched by computer，and the retrieval time was from the establishment of the database to March 17，2025. Two researchers independently searched and screened the literature，and evaluated the quality of the literature. RevMan 5.4 software was used for meta-analysis. Results A total of 8 studies involving 9 054 patients were included. The results of meta-analysis showed that，compared with the non-early mobilization group，early mobilization could reduce the mortality of ECMO patients，and the difference was statistically significant[RR=0.65，95%CI（0.46，0.93），P<0.001]. However，the effect on the duration of mechanical ventilation[SMD=-0.37，95%CI（-1.46，0.72），P=0.510] and ECMO support[SMD=-0.33，95%CI（-0.86，0.20），P=0.220] was not clear. In subgroup analysis，there was a statistically significant difference in mortality between patients with veno-venous extracorporeal membrane oxygenation（V-V ECMO） and veno-arterial extracorporeal membrane oxygenation（V-A ECMO）[RR=1.34，95%CI（1.05，1.71），P=0.020]. Conclusion The intervention of early mobilization can reduce the mortality of ECMO patients. But it is limited by the quality of the included studies，the number of subjects and the heterogeneity of study results，more high-quality studies are still needed to further verify the safety，feasibility and effectiveness of early mobilization in ECMO patients，and formulate professional progressive mobilization programs for different types of ECMO patients.

Key words： Extracorporeal Membrane Oxygenation; Early Mobilization; Nursing Care; Meta-Analysis

Cite this article

ZHANG Tianyu , CHENG Lingling , CHENG Zhen , SHAO Weiying , SHI Aili . The effect of early mobilization in adult patients with extracorporeal membrane oxygenation：a meta-analysis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026 , 7(5) : 616 -622 . DOI: 10.3761/j.issn.2096-7446.2026.05.017

References

[1] Karagiannidis C, Brodie D, Strassmann S, et al. Extracorporeal membrane oxygenation:evolving epidemiology and mortality[J]. Intensive Care Med, 2016, 42(5):889-896.
[2] Renner C, Jeitziner MM, Albert M, et al. Guideline on multimo-dal rehabilitation for patients with post-intensive care syndro-me[J]. Crit Care, 2023, 27(1):301.
[3] Esmealy L, Allahbakhshian A, Gholizadeh L, et al. Effects of early mobilization on pulmonary parameters and complications post coronary artery bypass graft surgery[J]. Appl Nurs Res, 2023, 69:151653.
[4] Munshi L, Kobayashi T, DeBacker J, et al. Intensive care phy-siotherapy during extracorporeal membrane oxygenation for acute respiratory distress syndrome[J]. Ann Am Thorac Soc, 2017, 14(2):246-253.
[5] Marhong JD, DeBacker J, Viau-Lapointe J, et al. Sedation and mobilization during venovenous extracorporeal membrane oxy-genation for acute respiratory failure:an international survey[J]. Crit Care Med, 2017, 45(11):1893-1899.
[6] Radfar J, Gilley C. P99:progressive mobilization protocol for pa-tients supported on ECMO via multidisciplinary culture change[J]. ASAIO J, 2023, 69(Supplement 2):167.
[7] Higgins JPT, Altman DG, G?tzsche PC, et al. The Cochrane Col-laboration’s tool for assessing risk of bias in randomised trials[J]. BMJ, 2011, 343:d5928.
[8] Stang A. Critical evaluation of the Newcastle-Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010, 25(9):603-605.
[9] Wan X, Wang WQ, Liu JM, et al. Estimating the sample mean and standard deviation from the sample size,median,range and/or interquartile range[J]. BMC Med Res Methodol, 2014, 14:135.
[10] Hayes K, Holland AE, Pellegrino VA, et al. Early rehabilitation during extracorporeal membrane oxygenation has minimal im-pact on physiological parameters:a pilot randomised con-trolled trial[J]. Aust Crit Care, 2021, 34(3):217-225.
[11] ECMO-PT Study Investigators, International ECMO Network. Early mobilisation during extracorporeal membrane oxygena-tion was safe and feasible:a pilot randomised controlled trial[J]. Intensive Care Med, 2020, 46(5):1057-1059.
[12] Rottmann FA, Noe C, Bemtgen X, et al. Survival outcomes and mobilization during venovenous extracorporeal membrane oxy-genation:a retrospective cohort study[J]. Front Med, 2023, 10:1271540.
[13] Tonna JE, Bailey M, Abrams D, et al. Predictors of early mo-bilization in patients requiring VV ECMO for greater than 7 days:an international cohort study[J]. Heart Lung, 2023, 62:57-63.
[14] Mayer KP, Pastva AM, Du GX, et al. Mobility levels with phy-sical rehabilitation delivered during and after extracorporeal membrane oxygenation:a marker of illness severity or an indication of recovery?[J]. Phys Ther, 2022, 102(3):pzab301.
[15] Rodriguez S, Sterling R, Tran R, et al. Vascular complications related to physical therapy:walking on ECMO[J]. J Am Coll Cardiol, 2020, 75(11):964.
[16] Bonizzoli M, Lazzeri C, Drago A, et al. Effects of a physio-thera-pic program in patients on veno-venous extracorporeal memb-rane oxygenation:an 8-year single-center experience[J]. Miner-va Anestesiol, 2019, 85(9):989-994.
[17] 中国医师协会呼吸医师分会危重症医学专业委员会, 中华医学会呼吸病学分会危重症医学学组. 体外膜式氧合治疗成人重症呼吸衰竭推荐意见[J]. 中华结核和呼吸杂志, 2019, 42(9):660-684.
  Critical Care Medicine Professional Committee of Respiratory Physicians Branch of Chinese Medical Doctor Association, Critical Care Medicine Group of Respiratory Medicine Branch of Chinese Medical Association. Recommendations for extra-corporeal membrane oxygenation in adults with severe acute respiratory failure[J]. Chin J Tuberc Respir Dis, 2019, 42(9):660-684.
[18] Abrams D, Madahar P, Eckhardt CM, et al. Early mobilization during extracorporeal membrane oxygenation for cardio-pulmonary failure in adults:factors associated with intensity of treatment[J]. Ann Am Thorac Soc, 2022, 19(1):90-98.
[19] Hodgson CL, Higgins AM, Bailey MJ, et al. Incidence of death or disability at 6 months after extracorporeal membrane oxygenation in Australia:a prospective,multicentre,registry-embedded cohort study[J]. Lancet Respir Med, 2022, 10(11):1038-1048.
[20] Huebner L, Warmbein A, Scharf C, et al. Effects of robotic-assisted early mobilization versus conventional mobilization in intensive care unit patients:prospective interventional cohort study with retrospective control group analysis[J]. Crit Care, 2024, 28(1):112.
[21] Snyder M, Njie BY, Grabenstein I, et al. Functional recovery in a cohort of ECMO and non-ECMO acute respiratory dis-tress syndrome survivors[J]. Crit Care, 2023, 27(1):440.
[22] 何茹, 迟秀文, 陶艳玲, 等. 早期活动在ICU机械通气病人康复中的应用[J]. 护理研究, 2021, 35(10):1803-1806.
  He R, Chi XW, Tao YL, et al. Application of early activities in rehabilitation of mechanically ventilated patients in ICU[J]. Chin Nurs Res, 2021, 35(10):1803-1806.
[23] Belletti A, Sofia R, Cicero P, et al. Extracorporeal membrane oxygenation without invasive ventilation for respiratory failure in adults:a systematic review[J]. Crit Care Med, 2023, 51(12):1790-1801.
[24] Gautier M, Joussellin V, Ropers J, et al. Diaphragm function in patients with Covid-19-related acute respiratory distress synd-rome on venovenous extracorporeal membrane oxygenation[J]. Ann Intensive Care, 2023, 13(1):92.
[25] Roncon-Albuquerque R Jr, Gai?o S, Vasques-Nóvoa F, et al. Standardized approach for extubation during extracorporeal membrane oxygenation in severe acute respiratory distress syndrome:a prospective observational study[J]. Ann Intensive Care, 2023, 13(1):86.
[26] Ramsey S, Shehatta AL, Ramanathan K, et al. Extracorporeal life support organization 2024 guideline for early rehabili-tation or mobilization of adult patients on extracorporeal mem-brane oxygenation[J]. ASAIO J, 2025, 71(3):187-199.
[27] Santhanam G, Chui B, Currie L. Early mobilization of patients receiving extra corporeal membrane oxygenation[J]. Cardiopu-lm Phys Ther J, 2022, 33(1):e7-e8.
[28] Shkurka E, Child H, Balls J, et al. Early rehabilitation and mo-bilisation of neonatal and paediatric extracorporeal membrane oxygenation patients:a UK and Ireland consensus document[J]. Perfusion, 2024, 39(1):174-181.
Options
Outlines

/

〈 〉