Document Detail


Restoring functional status: a long-term case report of severe lung and ventilatory muscle pump dysfunction involving recurrent bacterial pneumonias.
MedLine Citation:
PMID:  22833704     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person's functional status even after multiple years of mechanical ventilation dependency.
CASE DESCRIPTION: A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home. A 3-year study was approved and informed consent obtained for a home exercise program of resistive extremity and inspiratory muscle training along with exercise reconditioning. Tolerable distances walked, maximal inspiratory and expiratory pressures, hours spent on versus off mechanical ventilation, activities performed within and around her home, and community excursions taken were charted.
OUTCOMES: Daily time tolerated off the ventilator improved from less than one to 12 hours, distance walked in 6 minutes increased 33%, and maximal inspiratory and expiratory pressures improved 62% and 9.6% respectively. These improvements made out-of-home social excursions possible.
DISCUSSION AND CONCLUSIONS: This patient's functional status improved following multiple physical therapy interventions dictated by the evaluation of initial physical therapy examination findings according to the Guide to Physical Therapist Practice. Long term mechanical ventilator dependency in the home environment did not exclude this patient from achieving clinically significant gains in functional status even when having severe restrictive and obstructive ventilator impairment.
Authors:
Dennis C Sobush; Linda Laatsch; Randolph J Lipchik
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiopulmonary physical therapy journal     Volume:  23     ISSN:  1541-7891     ISO Abbreviation:  Cardiopulm Phys Ther J     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-07-26     Completed Date:  2012-08-23     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101155626     Medline TA:  Cardiopulm Phys Ther J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5-12     Citation Subset:  -    
Affiliation:
Department of Physical Therapy, Marquette University, Milwaukee, WI.
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Erratum In:
Cardiopulm Phys Ther J. 2012;Sep;23(3):47

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