Benefits of Physical Therapy Interventions for a Patient with End-Stage Pulmonary Disease who developed Right- Sided Heart Failure Requiring ECMO Support Bridging to Lung Transplantation

Samantha Mancuso, Kirby Mayer and Anil Gonipath

Rehabilitation Sciences Doctoral Program, University of Kentucky, USA
Both the authors contributed equally

^*Correspondance to: Kirby Mayer 

 PDF  Full Text Case Report | Open Access

Abstract:

Background: Extracorporeal Membrane Oxygenation Support (ECMO) is the highest level of life support. The purpose of this case report is to establish the multi-disciplinary approach to rehabilitation in a novel patient case. The report establishes the safety and importance of rehabilitation interventions during two phases of the patient’s critically complex medical course.Case
Presentation: A 50-year-old male diagnosed with advanced idiopathic pulmonary fibrosis that required ECMO support as a bridge to lung transplantation. During the pre-transplantation phase, the patient suffered significant decline leading to the development of right-sided heart failure and acute kidney injury. The severity of his medical condition required multiple re-configurations of the ECMO circuit to maximize cardio-respiratory support. Rehabilitation interventions were implemented during both pre- and post-transplant stages with emphasis placed on a multidisciplinary approach to delivery of interventions.Outcomes: On day 50, the patient underwent successful bilateral lung transplantation. During both phases, there were no adverse events during any rehabilitation session. In addition, the patient progressed from fully dependent in the initial stages to a modified independence state at hospital discharge. The complicated and novel case (IPF developing right sided heart failure requiring multiple cannulation strategies) demonstrates the feasibility and importance of physical therapy to improve pre-transplantation status as well as maximize outcomes following surgery.Discussion: There is limited evidence describing rehabilitation interventions for critically ill patients requiring ECMO support. This case report confirms that physical therapy can be safely implemented in the most complex cases. The case report also attempts to show the importance of implementing physical therapy to best prepare the patient for transplantation surgery.

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Cite the Article:

Mancuso S, Mayer K, Gonipath A. Benefits of Physical Therapy Interventions for a Patient with End- Stage Pulmonary Disease who developed Right-Sided Heart Failure Requiring ECMO Support Bridging to Lung Transplantation. Ann Clin Case Rep. 2017; 2: 1402.