Rehabilitation Intensity and Discharge Outcomes in Venovenous Extracorporeal Membrane Oxygenation Used as a Bridge to...

Early rehabilitation during venovenous extracorporeal membrane oxygenation used as a bridge to recovery (VV ECMO-BTR) may help preserve functional capacity. We retrospectively analyzed 153 adults supported with VV ECMO-BTR who received at least one physical therapy (PT) session and remained on ECMO for at least 7 days. Rehabilitation intensity was defined as PT sessions per ECMO day, and the primary outcome was discharge disposition, categorized as favorable (home or postacute rehabilitation) or unfavorable (long-term acute care or death). Favorable outcomes occurred in 28.8% of patients, who received significantly higher rehabilitation intensity than those with unfavorable outcomes (0.40 vs. 0.24 sessions/day, p < 0.001). In multivariable analysis using prespecified physiologic and functional covariates, rehabilitation intensity remained independently associated with favorable discharge (odds ratio 15.2, 95% confidence interval 2.00-145.0, p = 0.012). An exploratory threshold of 0.33 sessions per ECMO day demonstrated moderate discriminative ability (area under the curve [AUC] 0.751). These findings suggest that higher rehabilitation intensity during VV ECMO-BTR is independently associated with favorable discharge disposition, and consistent mobilization may reflect both physiologic resilience and a potentially modifiable therapeutic exposure during ECMO.