1,720,977 research outputs found
Handgrip Strength in Lung Transplant Candidates and Recipients
No full textObjectives: Handgrip strength is increasingly used to assess muscle strength in various conditions. In this review, we investigated handgrip strength in patients receiving or awaiting lung transplant.Materials and Methods: For this integrative review, we searched 8 databases from inception through February 2023. Two keyword entries, '' handgrip strength '' and '' lung transplantation,'' were matched using the Boolean operator, AND. No filters were applied for document type, age, sex, publication date, language, and subject.Results and Conclusions: The searched databases returned 73 citations. Nine articles considering 487 patients (49% female) were included in the final analysis; 7 studies were observational, and 2 were randomized controlled trials. In 7 of 9 studies, handgrip strength was measured with a hydraulic dynamometer. In candidates for lung transplant, handgrip strength ranged from 27.1 kg (before rehabilitation) to 31.2 kg (after rehabilitation). In lung transplant recipients, handgrip strength ranged from 21.1 kg (before rehabilitation) to 35.7 kg (after rehabilitation). Handgrip strength in lung transplant candidates with chronic obstructive pulmonary disease was higher (89 +/- 18% predicted) versus patients with interstitial lung disease (79 +/- 18% predicted). Improvements in maximal inspiratory pressure and maximal expiratory pressure were observed in those patients whose handgrip strength improved after rehabilitation. Nonsarcopenic patients walked longer distances for the 6-minute walking test (> 450 m) versus sarcopenic patients ( 20 kg) versus sarcopenic patients (< 20 kg). Handgrip strength testing should be implemented both in preoperative and postoperative contexts to evaluate physical potential of patients and drive rehabilitative activities toward the most impaired domains
Extracorporeal lung support for hypercapnic ventilatory failure
No full textExtracorporeal lung support can be achieved using extracorporeal membrane oxygenation (ECMO) and extracorporeal CO2 removal. The ECMO systems allow a total lung support, providing both blood oxygenation and CO2 removal. Unlike ECMO, extracorporeal CO2 removal refers to an extracorporeal circuit that provides a partial lung support and selectively extracts CO2 from blood. The concept of partial extracorporeal lung support by removing only CO2 without effect on oxygenation was first proposed in 1977 by Kolobow and Gattinoni, with the aim to reduce breathing frequency, ventilator tidal volumes, and inspiratory pressures, facilitating lung-protective ventilation. Patients with end-stage chronic lung disease can survive, while waiting for lung transplantation, only if treated with mechanical ventilation or extracorporeal lung support. ECMO has been considered a suitable approach as a bridge to lung transplantation for patients with advanced respiratory failure waiting for lung transplantation. Extracorporeal CO2 removal has been proposed for the treatment of COPD patients suffering from exacerbation to avoid invasive mechanical ventilation. The rationale is to combine the improvement of alveolar ventilation by using noninvasive ventilation with muscle unload provided by removing CO2 directly from the blood, using an extracorporeal device. Increasing attention has been given to the possibility of patients performing a variety of physical activities while receiving extracorporeal lung support. This is possible thanks to the continuous development of technology together with the customization of sedative protocols. Awake extracorporeal support is a specific approach in which the patient is awake and potentially cooperative while receiving ECMO. The present analysis aims to synthesize the main results obtained by using extracorporeal circuits in patients with respiratory failure, particularly in those patients with hypercapnia. Key words: extracorporeal membrane oxygenation; physiotherapy; respiratory insufficiency; critical illness; lung transplantation; survival; CO2. [Respir Care 2018;63(9):1174–1179. © 2018 Daedalus Enterprises]
Elastic Band Exercises for Patients with Intensive Care Unit-Acquired Weakness: A Case Report
No full textIntensive care unit-acquired weakness is characterised by severe impairment of muscle function that often arises after prolonged mechanical ventilation, difficult weaning, and severe sepsis. Elastic band exercises constitute an inexpensive and simple technique that is quite appealing for implementation in a "protected environment" such as the intensive care unit; however, elastic band application in the intensive care unit and in critical patients has not yet been described. A 72-year-old male was referred to the respiratory intensive care unit for hypoxemic respiratory failure due to acute respiratory distress syndrome. Upper limb active exercises were performed using an elastic band exploring three main movement rays: abduction, forward flexion, and external rotation. At discharge, major improvements were observed for upper limb activities. The patient was also able to maintain a sitting position at the edge of the bed starting from day 27. We found that an elastic band exercise program in a critical ill patient recovering from intensive care unit-acquired weakness was a suitable, safe, viable, and inexpensive therapeutic option to preserve residual upper limb motor activities and improve trunk control
Does Preoperative Rehabilitation Influence the Quality of Life in Patients Who Are Candidates for Lung Transplant?
Full text linkObjectives: Lung transplant is an excellent therapeutic option for patients with advanced/end-stage pulmonary disease. The purpose of this review was to define whether preoperative rehabilitation influences quality of life in patients who are candidates for lung transplant.Materials and Methods: This was a scoping review conducted by searching 4 primary databases from inception until January 2022. Three keywords, "lung transplantation," "preoperative rehabilitation," and "quality of life," were matched using the Boolean operator AND. In each database, the following fields were searched: PubMed (all fields), Scopus (title, abstract, keywords), Cochrane Library (title, abstract, keywords), and Web of Science (topic). Filters were applied for age (adult only) and language (English only). No filters were applied for gender, publication date, and subject. The search process was completed in January 2022.Results and Conclusions: We retrieved 57 citations from these databases. After removal of duplicates, 41 documents were screened for eligibility. Two articles were included in the final analysis: 1 was a systematic review, and 1 was an observational prospective study. The rehabilitative interventions were mainly focused on motor and breathing exercises and were integrated by education programs. Preoperative rehabilitation was effective at improving quality of life and mood status and reducing dyspnea in patients waiting for lung transplant. In addition, the 6-minute walking distance increased after patients participated in preoperative rehabilitation. Preoperative rehabilitation was composed of different types of exercise with variable duration (3-20 weeks) and frequency (3-6 times per week). Patients on the active wait list for lung transplant should be encouraged to attend preoperative rehabilitation in order to preserve and improve their quality of life
Assessment of Symptoms in Patients with COPD: Strengths and Limitations of Clinical Scores
No full textPurpose of Review: Health questionnaires are valuable tools to quantify, in an objective and standardized manner, the impact of chronic obstructive pulmonary disease on the health status of patients and on their well-being, and to track changes over time.Therefore, filling out these questionnaires allows clinicians to obtain the necessary information that can be easily related to clinical outcomes. Recent Findings: Most importantly, symptoms’ assessment represents a very relevant part of these clinical tools when applied to patients suffering from chronic respiratory diseases. Comparing scores between visits is also indicative of the patient’s health status, as changes in quality of life are related to worse outcomes such as hospitalization and exacerbation. However, each respiratory questionnaire may be peculiar in catching specific aspects of a similar symptom (i.e., dyspnoea); therefore, different tools are not interchangeable or comparable.Summary: Detecting the minimal clinically important difference is a necessary evaluation procedure which affords the change inpatient’s management and directs the therapeutic action towards more active treatments
Hemidiaphragm elevation after thoracic and cardiac surgical procedures: there is room for respiratory physiotherapy
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Dyspnea and Fatigue Following Video-assisted Thoracic Surgery for Pulmonary Lobectomy: Measuring Scales to Optimize the Allocation of Resources
No full textMagnetic Stimulation Therapy in Patients with COPD: A Systematic Review
No full textMagnetotherapy (MT) is a therapeutic treatment based on the use of magnetic fields (MF) that can have an anti-inflammatory and analgesic effect. MT represents a possible treatment or an ancillary therapeutic intervention for a wide range of diseases and it is often used in the field of physiotherapeutic practices. A crucial point in the treatment of chronic obstructive pulmonary disease (COPD) patients, to counteract muscular depletion and respiratory symptoms, is represented by physiotherapy. Nevertheless, the knowledge about the application of MF as a therapeutic option in COPD patients is very limited. The purpose of the present study was to define what is currently known about the use of MF in patients with COPD. A systematic review of the literature was conducted during the month of October 2017, searching three main databases. Only those citations providing detailed informations about the use of MF to treat COPD symptoms either during an acute or a chronic phase of the disease, were selected. Following the selection process three articles were included in the final analysis. The present review focused on a total of thirty-six patients with COPD, and on the effects of the application of MF. In the majority of cases, the treatment sessions with MF were carried-out in an outpatient setting, and they differed with regard to the duration; frequency of application; dosage; intensity of the applied MF. Basing on the available informations, it seems that MF is a feasible, well tolerated, safe therapeutic option, for the treatment of motor-related COPD symptoms
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