Challenges of physiotherapy service on a patient with cystic fibrosis and severe pulmonary exacerbation and put on extracorporeal membrane oxygenation: A case report

Abstract

A 14-year-old male with cystic fibrosis (CF) and severe pulmonary exacerbation was put on venovenous extracorporeal membrane oxygenation (VV-ECMO) and mechanical ventilator. This case report is to share the challenges and vigilant care on service delivery of physiotherapy services faced and gone through at a pediatric intensive care unit of a quaternary care children’s hospital. Sputum clearance technique was provided in the coexistence of VV-ECMO and mechanical ventilator. Inspiratory muscle training and physical rehabilitation commenced at the phase of progressive weaning from noninvasive ventilation. The total intervention duration was 40 days; the lung sound and chest X-ray were cleared up, and the physical tolerance was improved to walking with light assistance. Airway clearance and physical rehabilitation in CF on VV-ECMO are achievable with alertness and alternatives with careful observance. Although ECMO may hinder the efficacy of sputum clearance, cautious and safe-guarded physiotherapy techniques can influence outcomes.