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J Cardiopulm Rehabil Prev · Jul 2020
Review Case ReportsFeasibility and Efficacy of the Pulmonary Rehabilitation Program in a Rehabilitation Center: CASE REPORT OF A YOUNG PATIENT DEVELOPING SEVERE COVID-19 ACUTE RESPIRATORY DISTRESS SYNDROME.
- Simone Pancera, Silvia Galeri, Roberto Porta, Irene Pietta, Luca Nicola Cesare Bianchi, Maria Chiara Carrozza, and Jorge Hugo Villafañe.
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy (Drs Pancera, Galeri, Porta, Bianchi, Carrozza, and Villafañe and Ms Pietta); and Department of Information Engineering, University of Brescia, Brescia, Italy (Dr Pancera).
- J Cardiopulm Rehabil Prev. 2020 Jul 1; 40 (4): 205-208.
Details Of The Clinical CaseA 51-yr-old man underwent a respiratory rehabilitation program (RRP), after being tracheostomized and ventilated due to acute respiratory distress syndrome (ARDS) from coronavirus disease-2019 (COVID-19) infection. Respiratory care, early mobilization, and neuromuscular electrical stimulation were started in the ad hoc isolation ward of our rehabilitation center. At baseline, muscle function was consistent with intensive care unit-acquired weakness and the patient still needed mechanical ventilation (MV) and oxygen support. During the first week of RRP in isolation, the patient was successfully weaned from MV, the tracheal cannula was removed, and the walking capacity was recovered. At the end of the RRP, continued in a standard department, respiratory muscles strength increased by 7% and muscle function improved as indicated by the quadriceps size enlargement of 13% and the change of the Medical Research Council sum score from 48/60 to 58/60.DiscussionProviding RRP in patients with severe COVID-19 ARDS involves risks for operators and organizational difficulties, especially in rehabilitation centers; nevertheless, its continuity is important to prevent the development of permanent disabilities in previously healthy subjects. Limited to the experience of only one patient, we were able to carry out a safe RRP during the COVID-19 pandemic, promoting the complete functional recovery of a COVID-19 young patient.SummaryMost patients who develop serious consequences of COVID-19 infection risk a reduction in their quality of life. However, by organizing and directing specialized resources, subacute rehabilitation facilities could ensure the continuity of the RRPs even during the COVID-19 pandemic.
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