Stepping it Up on Temporary Mechanical Circulatory Support: Mobilization and Prehabilitation of Patients in ICUs

Early mobilization and prehabilitation in patients supported with temporary mechanical circulatory support (tMCS) have emerged as promising strategies to mitigate the deconditioning and sarcopenia associated with critical illness and immobility. While small studies have demonstrated that ambulation with tMCS is both safe and feasible in selected patients, significant variability exists in practice patterns across centers. Implementation of early mobility protocols requires a multidisciplinary team, including cardiology, surgery, critical care, physical therapy, respiratory therapy, nursing, and nutrition supported by dedicated personnel, familiar with the unique considerations of tMCS devices. Despite increasing adoption, there remains a paucity of high-quality data evaluating the impact of early ambulation on clinical outcomes, functional recovery, and candidacy for advanced therapies. This review outlines current practices, key challenges, and emerging strategies in tMCS rehabilitation and calls for standardized protocols and prospective studies to guide optimal implementation across institutions.