Use of Structured Exercise Program With Resistance Training for Veno-Venous Extracorporeal Membrane Oxygenation After Lung Transplantation: A Case Report

Extracorporeal membrane oxygenation (ECMO) is crucial in the management of severe cardiopulmonary dysfunction. Although early rehabilitation in the intensive care unit (ICU) has been shown to reduce ICU-acquired weakness and improve patient outcomes, there is limited evidence on structured rehabilitation programs for patients on veno-venous ECMO (VV-ECMO) for the treatment and management of their disease process. Herein, a case of a multidisciplinary progressive rehabilitation program with a focus on resistance training that enhanced functional improvement in a patient on VV-ECMO after lung transplantation is reported. A female in her sixties with a history of idiopathic pulmonary fibrosis underwent lung transplantation but subsequently developed acute respiratory distress syndrome requiring VV-ECMO on postoperative day 13. A high-intensity rehabilitation protocol, which included ambulation, passive through active range of motion exercises, physical/occupational therapy, and resistance training, was implemented on postoperative day 16. The patient demonstrated progressive improvement in exercise tolerance, resistance training duration, gait distance, and functional strength. This case highlights the potential benefits of high-intensity rehabilitation to enhance physical function and mobility in patients on VV-ECMO. Further research is warranted to evaluate the effectiveness of the high-intensive rehabilitation and to establish standardized rehabilitation protocols in VV-ECMO settings.