Management of a patient with lung metastases requiring Prolonged Mechanical Ventilation (PMV): Rehabilitation and recovery of function Journal Article

Authors: Kendig, T. D.; Nonaillada, J.; Ramaker, J.; Samuels, F.
Article Title: Management of a patient with lung metastases requiring Prolonged Mechanical Ventilation (PMV): Rehabilitation and recovery of function
Abstract: Background and Purpose: Existing iterature demonstrates the beneficial impact of rehabilitation interventions on functional status in patients necessitating prolonged mechanical ventilation (PMV).1-3 However, there appears to be a void in the literature addressing the effects of specific physical (PT) and occupational therapy (OT) interventions on functional status of persons with PMV in the context of the acute care oncology setting. This case report describes the PT and OT management of a patient with PMV in the acute care oncology setting. Case Description: The patient in this case report is a 41-year-old woman with metastatic breast cancer and malignant pleural effusions who required PMV following an acute episode of respiratory failure. Examination and Intervention: The patient presented with deconditioning, decreased strength, and decreased functional status upon PT and OT initial evaluation. Targeted and intense PT and OT interventions including deep breathing exercises, limb strengthening, reconditioning, functional training, and early mobilization were implemented. Outcomes: Primary outcomes of interest were level of function qualified by need for assistance as defined on the FIM and ambulation distance. Following PT and OT, the patient showed substantial gains in functional status. She was weaned from the ventilator and was discharged home to resume her role as mother. Discussion and Conclusion: Consistency between the outcomes of previous studies examining the effects of rehabilitation on functional status among persons with PMV and KB's experience lends support to the use of this management approach for patients with PMV the acute care oncology setting.1-3.
Keywords: adult; constipation; case report; doxorubicin; diarrhea; capecitabine; paclitaxel; multiple cycle treatment; breast cancer; mastectomy; nausea; vomiting; midazolam; cyclophosphamide; intensive care unit; lung metastasis; pleura effusion; occupational therapy; methylprednisolone; navelbine; convalescence; tracheostomy; physiotherapy; rehabilitation care; artificial ventilation; respiratory failure; tinzaparin; breathing exercise
Journal Title: Rehabilitation Oncology
Volume: 26
Issue: 2
ISSN: 2168-3808
Publisher: American Physical Therapy Association  
Date Published: 2008-01-01
Start Page: 3
End Page: 14
Language: English
PROVIDER: scopus
Notes: --- - "Export Date: 17 November 2011" - "Source: Scopus"