Implementation of Early Mobilization Protocols for ECMO Patients in the ICU: Clinical Review and Institutional Experience from a Tertiary Care Center in Saudi Arabia

Background: Extracorporeal Membrane Oxygenation (ECMO) represents an advanced life support technique employed in instances of severe cardiac or respiratory failure. Although ECMO significantly improves patient survival rates, extended stays in the intensive care unit (ICU) can result in complications such as ICU-acquired weakness and long-term functional disabilities. Early mobilization (EM) has emerged as a crucial intervention to mitigate these risks; however, its implementation among ECMO patients is often inconsistent, particularly within Saudi Arabia. Aim of the Study: This study aims to investigate the implementation of early mobilization (EM) guidelines for ECMO patients in a tertiary healthcare facility in Saudi Arabia. It seeks to identify key indications and contraindications for EM, assess barriers to its application, and develop as well as validate a standardized EM protocol for ECMO patients that can be utilized by healthcare providers across Saudi Arabia. Methods: Multidisciplinary approach was employed, involving clinical review assessments of patients’ readiness, indication, contraindications, safety protocols, guidelines, and monitoring parameters. The study analyzed existing EM practices, guidelines and the challenges faced by healthcare providers, particularly in the context of limited staffing, awareness and resources. Conclusion: The findings underscore the urgent need for standardized, evidence-based guidelines to facilitate the systematic implementation of EM in ECMO settings. By addressing safety considerations and promoting interdisciplinary teamwork, knowing the indications and contraindications, the study advocates for the integration of EM as a routine practice in the management of critically ill patients receiving ECMO. This approach aims to improve recovery trajectories and reduce the adverse effects associated with prolonged immobility in ICU environments, by using a standardize EM guidelines.