Drop foot post-ECMO, subsequently complicated by third-degree burns: A case report based on user portrait and health management journey map

Abstract

Rationale: The long-term complications of extracorporeal membrane oxygenation (ECMO) have not been well documented, especially the rare lower extremity drop foot (LEDF). Understanding the mechanisms and management of such complications is critical to improving patient outcomes. What is the role of patient-based on user portrait and health management journey map (HMJM) for rehabilitation management of patients with post-intensive care syndrome (PICS)?

Patient concerns: We reported a case of a patient who developed LEDF after receiving ECMO for severe heart failure. The patient's user profile revealed a 17-year-old female athlete with a past history of hypertension. After treatment with ECMO, the patient developed LEDF with loss of sensation and motor deficits resulting in third-degree burns, which were inadvertently caused by using an electric stove for heating in the winter. During her hospitalization, she experienced several medical interventions and became more sensitive to pain and dysfunction perception. After discharge from the ICU, the patient reported significant difficulties in mobility, quality of life, and mental health.

Diagnoses: The diagnosis of LEDF was confirmed by clinical electromyography, third-degree burns were assessed using the burn assessment criteria, and the scale confirmed PICS.

Interventions: User portrait and HMJM provided patients with personalized integrated rehabilitation care from a multidisciplinary team. This included physical and pharmacological treatment for foot drop. A skin graft was applied to the burned area. In addition, psychotherapy was received during the peri-rehabilitation period.

Outcomes: Despite comprehensive interventions, the patient showed only partial recovery of foot function and required long-term rehabilitation and assistive devices for daily activities. However, mental health performance was better than before.

Lessons: This case highlighted the importance of monitoring patients with ECMO for neuromuscular injuries, such as LEDF. The need for early intervention to prevent secondary injuries, such as burns. It also demonstrated the value of user portrait and HMJM in guiding individualized rehabilitation care plans for PICS.

Keywords: ECMO complications; health management journey map; lower extremity drop foot; patient user portrait; post-ICU syndrome; rehabilitation; third-degree burn.