ECMO Physiotherapy network.
This can be Veno-Arterial ‘VA’ ECMO (supporting the heart and lungs), or Veno-Venous ‘VV’ ECMO (supporting the lungs). VA ECMO is used in cardiac centres, whereas VV ECMO is only provided in specialist Severe Acute Respiratory Failure (SARF) centres.
ECMO has been used as a rescue therapy for severe respiratory failure since the 1970s. Following a major randomised controlled trial (Peek et al, 2006) and the subsequent flu pandemics from 2009 onwards, a dedicated UK Respiratory ECMO service was commissioned by NHS England in 2011.
There are 8 UK centres commissioned to provide adult Respiratory ECMO support are:
Scotland:
- Aberdeen Royal Infirmary (NHS Grampian)
England:
- Wythenshawe Hospital, (University of Manchester NHS Foundation Trust)
- Glenfield Hospital (University Hospitals of Leicester NHS Foundation Trust)
- Royal Papworth Hospital NHS Foundation Trust
- Royal Brompton and Harefield NHS Foundation Trust (Guy’s and St Thomas’ NHS Foundation Trust)
- St Thomas’ Hospital (Guy’s and St Thomas’ NHS Foundation Trust)
- Bartholomew’s Hospital (Barts Health NHS Trust)
- Bristol Royal Infirmary (University Hospitals Bristol NHS Foundation Trust)
Mater Hospital (Dublin) also provides VV ECMO services to the Republic of Ireland.
A network map of referral areas and contact details for each centre within the UK and Ireland can be found here.
Physiotherapy leaders from the nine UK and Ireland ECMO centres are members of the ECMO Physiotherapy Network. Biannual meetings take place for peer support, sharing of best practice, and governance activity including audit and research.
Physiotherapists who occasionally encounter ECMO or are treating patients after ECMO treatment are encouraged to contact the group for support and advice.
Physiotherapists provide both rehabilitative and respiratory physiotherapy interventions to patients during and after ECMO support.
You can also follow the ECMO Physiotherapy Network on Twitter @ECMO_physio or email: ukecmophysionetwork@gmail.com
A number of resources have been developed by members of the ECMO Physiotherapy Network available to download using the links below:
Eden A, Purkiss C, Cork G, et al. In-patient physiotherapy for adults on veno-venous extracorporeal membrane oxygenation – United Kingdom ECMO Physiotherapy Network: A consensus agreement for best practice. Journal of the Intensive Care Society. 2017;18(3):212-220. doi:10.1177/1751143717705801
Presentations form Euro ELSO 2022
Range of Movement Assessment & Positioning
Assessment and Safety Considerations of Rehabilitation
Further information on ECMO may be found using the links below:
NICE IPG391 Extracorporeal membrane oxygenation for severe acute respiratory failure in adults
NICE IPG482 Extracorporeal membrane oxygenation (ECMO) for acute heart failure in adults
- Physiotherapy for patients on extracorporeal membrane oxygenation support: How, When and Who. An international EuroELSO survery. Polastri, M., Eden, A., Loforte, A., Dell’Amore, A., Antonini, M., Riera, J., Barrett, N & Swol, J. Perufsion. 2022. DOI: 10.1177/02676591221133657
- Outcomes of the NHS England national extracorporeal membrane oxygenation service for adults with respiratory failure; a multicentre observational cohort study. Warren, A., Chiu, Y., Villar, S., Fowles, J. et al. BJA, 2020. 125 (3), 259-266. DOI https://doi.org/10.1016/j.bja.2020.05.065
- Extracorporeal membrane oxygenation and rehabilitation in patients with COVID-19: A scoping review. Polastri, M., Swol, J., Lorforte, A. & Dell’Amore, A. Artifical Organs. 2022. 46:30-39. DOI: 10.1111/aor.14110
- How I wean patients from veno-venous extra-corporeal membrane oxygenation. Vasques, F., Romitti, F., Gattinoni, L & Camporota, L. Critical Care. 2019. 23:316. https://doi.org/10.1186/s13054-019-2592-5
- https://www.england.nhs.uk/wp-content/uploads/2018/07/Extra-corporeal-membrane-oxygenation-service-for-adults-with-cardiac-failure.pdf
- Physiotherapy for Patients on Awake Extracorporeal membrane Oxygenation: A Systematic Review. Polastri, M., Loforte, A., Dell’Amore, A. & Nava S. Physiotherapy Research International. 2015. 21(4), 203-209. https://doi.org/10.1002/pri.1644
- Physiotherapy on ECMO: Mobility and beyond. Morris, K. & Osman, L. 2017. Qatar Medical Journal, Volume 2017, Issue 1 - Extracorporeal Life Support Organisation of the South and West Asia Chapter 2017 Conference Proceedings, DOI: https://doi.org/10.5339/qmj.2017.swacelso.58
- Early physiotherapy in the clinical course of patients on Veno-Venous Extracorporeal Membrane Oxygenation. Bonizzoli, M., Lazzeri, C., Drago, A., Tadini Boninsegni, L., Donati, M., Di Valvasone, A., Pesenti, A. & Peris, A. European Respiratory Journal 2018 52: PA1415; DOI: 10.1183/13993003.congress-2018.PA1415
- Safety and potential benefits of physical therapy in adult patients on extracorporeal membrane oxygenation support: a systematic review. Ferreira DDC; Marcolino MAZ; Macagnan FE; Plentz RDM; Kessler A. Revista Brasileira de terapia intensiva; May 2019; vol. 31 (no. 2); p. 227-239 DOI: 10.5935/0103-507X.20190017
- Effects of a physiotherapic program in patients on veno-venous extracorporeal membrane oxygenation: an 8-year single-center experience. Bonizzoli M; Lazzeri C; Drago A; Tadini Boninsegni L; Donati M et al. Minerva anestesiologica; Sep 2019; vol. 85 (no. 9); p. 989-994 DOI: 10.23736/S0375-9393.19.13287-7
- Acute skeletal muscle wasting and relation to physical function in patients requiring extracorporeal membrane oxygenation (ECMO). Hayes K; Holland AE; Pellegrino VA; Mathur S; Hodgson CL. Journal of critical care; 2018; vol. 48 ; p. 1-8 DOI: 10.1016/j.jcrc.2018.08.002
EPN ACPRC article May 2026
The UK ECMO Physiotherapy Network met at St Bartholomew's Hospital on 12 May for its biannual face-to-face meeting. The network, which brings together physiotherapists working across VA and VV ECMO centres throughout the UK, meets twice yearly — once in person and once virtually.
Representatives from 15 ECMO centres shared updates on service activity, developments, and interesting clinical cases. With continued growth of the network, discussions focused on expanding the structure beyond the existing Chair role with additional Deputy Chair, and Media Lead roles. Other additional roles include leads for education, research, and follow-up clinics, aligning with the wider UK ECMO Network subgroup structure.
The network continues to strengthen its professional profile and educational resources. Members currently utilise dedicated website space hosted by the ACPRC to share information about ECMO services and physiotherapy practice with the wider respiratory physiotherapy community. There is also an exciting opportunity to develop a physiotherapy-specific section within the wider UK ECMO Network website, helping showcase the valuable contribution physiotherapists make within the multidisciplinary ECMO team. The group also agreed to use the NHS Futures platform to securely store and share ECMO Physiotherapy Network documents and resources between centres.
The group also discussed the recent national ECMO physiotherapy treatment service evaluation submitted to the Journal of the Intensive Care Society (JICS). The project was supported through a small grant from ACPRC, for which the network expressed its gratitude. Plans are also underway to update the ECMO Physiotherapy Consensus document later this year.
Over the past year, collaboration across AHP ECMO networks has continued to grow. Strong links have developed with OT, SaLT, Dietetic, and Paediatric ECMO networks. Particular recognition was given to Emma Shkurka, who also represents AHPs on the EuroELSO Scientific Committee. This collaborative work has contributed to increased AHP representation at this year’s EuroELSO conference, with network members providing positive feedback on the event.
Alongside the professional programme, attendees enjoyed a tour of the magnificent Great Hall at Barts, renowned for its remarkable 900-year history. Afternoon educational sessions included a presentation from Dr Alastair Proudfoot on cardiogenic shock and ECMO, and a session from Matt Fuller on rehabilitation, amputees, and vascular complications.
As always, the meeting provided a valuable opportunity for collaboration, knowledge sharing, and peer support. The network extends its thanks to ACPRC for supporting travel costs for members unable to secure funding through their individual Trusts.
