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Niu C, Lin H, Zhang Z, Wang Q, Wei Y. Impact of pulmonary rehabilitation on exercise capacity, health-related quality of life, and cardiopulmonary function in lung surgery patients: a retrospective propensity score-matched analysis. Front Med (Lausanne) 2024; 11:1450711. [PMID: 39188876 PMCID: PMC11345222 DOI: 10.3389/fmed.2024.1450711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 07/22/2024] [Indexed: 08/28/2024] Open
Abstract
Background Pulmonary rehabilitation is considered beneficial for patients undergoing lung surgery, yet its specific impacts on exercise capacity, health-related quality of life (HRQL), and cardiopulmonary function require further elucidation. This study aimed to evaluate the effect of PR on these outcomes in patients undergoing lung surgery using a retrospective propensity score-matched analysis. Methods We retrospectively analyzed 420 patients with non-small cell lung cancer (NSCLC) who underwent lung surgery from January 2022 to May 2024. Among these, 84 patients received PR while 336 did not (control group). Propensity score matching (PSM) at a 1:1 ratio yielded 46 patients in each group. Baseline characteristics, spirometry, cardiopulmonary exercise testing, respiratory muscle strength, HRQL, and muscle measurements were assessed pre-and post-surgery. Results Before PSM, significant differences existed between groups, with the PR group being older and having different pulmonary function baselines. After PSM, groups were well-balanced. Postoperatively, the PR group showed significant improvements in FEV1/FVC (64.17% vs. 50.87%, p < 0.001), FEV1 (2.31 L/min vs. 1.75 L/min, p < 0.001), and predicted FVC percentage (88.75% vs. 68.30%, p < 0.001). Cardiovascular responses showed a lower CI during exercise in the PR group post-PSM (6.24 L/min/m2 vs. 7.87 L/min/m2, p < 0.001). In terms of exercise capacity, the PR group had higher maximal WR percentage (104.76% vs. 90.00%, p = 0.017) and peak VO2 (1150.70 mL/min vs. 1004.74 mL/min, p = 0.009). PR also resulted in less leg soreness and lower total CAT scores postoperatively. Muscle measurements indicated significantly smaller reductions in ΔHUESMCSA and percentage change in the PR group. Conclusion Pulmonary rehabilitation significantly enhances exercise capacity, HRQL, and cardiopulmonary function in patients undergoing lung surgery. It also mitigates postoperative muscle loss, underscoring its importance in the postoperative management of lung surgery patients.
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Affiliation(s)
- Chunlai Niu
- Department of Respiratory and Critical Care Rehabilitation, Shanghai Second Rehabilitation Hospital, Shanghai, China
| | - Huan Lin
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Zinan Zhang
- Department of Respiratory and Critical Care Rehabilitation, Shanghai Second Rehabilitation Hospital, Shanghai, China
| | - Qing Wang
- Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingjun Wei
- Department of Respiratory and Critical Care Rehabilitation, Shanghai Second Rehabilitation Hospital, Shanghai, China
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He S, Meng D, Wei M, Guo H, Yang G, Wang Z. Proposal and validation of a new approach in tele-rehabilitation with 3D human posture estimation: a randomized controlled trial in older individuals with sarcopenia. BMC Geriatr 2024; 24:586. [PMID: 38977995 PMCID: PMC11232209 DOI: 10.1186/s12877-024-05188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE Through a randomized controlled trial on older adults with sarcopenia, this study compared the training effects of an AI-based remote training group using deep learning-based 3D human pose estimation technology with those of a face-to-face traditional training group and a general remote training group. METHODS Seventy five older adults with sarcopenia aged 60-75 from community organizations in Changchun city were randomly divided into a face-to-face traditional training group (TRHG), a general remote training group (GTHG), and an AI-based remote training group (AITHG). All groups underwent a 3-month program consisting of 24-form Taichi exercises, with a frequency of 3 sessions per week and each session lasting 40 min. The participants underwent Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-meter walking pace, Timed Up and Go test (TUGT), and quality of life score (QoL) tests before the experiment, during the mid-term, and after the experiment. This study used SPSS26.0 software to perform one-way ANOVA and repeated measures ANOVA tests to compare the differences among the three groups. A significance level of p < 0.05 was defined as having significant difference, while p < 0.01 was defined as having a highly significant difference. RESULTS (1) The comparison between the mid-term and pre-term indicators showed that TRHG experienced significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05); GTHG experienced extremely significant improvements in 6-meter walking pace and QoL (p < 0.01); AITHG experienced extremely significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05). (2) The comparison between the post-term and pre-term indicators showed that TRHG experienced extremely significant improvements in TUGT timing test (p < 0.01); GTHG experienced significant improvements in ASMI and TUGT timing test (p < 0.05); and AITHG experienced extremely significant improvements in TUGT timing test (p < 0.01). (3) During the mid-term, there was no significant difference among the groups in all tests (p > 0.05). The same was in post-term tests (p > 0.05). CONCLUSION Compared to the pre-experiment, there was no significant difference at the post- experiment in the recovery effects on the muscle quality, physical activity ability, and life quality of patients with sarcopenia between the AI-based remote training group and the face-to-face traditional training group. 3D pose estimation is equally as effective as traditional rehabilitation methods in enhancing muscle quality, functionality and life quality in older adults with sarcopenia. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov (NCT05767710).
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Affiliation(s)
- Shichun He
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Deyu Meng
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Hongzhi Guo
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA
- Graduate School of Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan
| | - Guang Yang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Ziheng Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA.
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan.
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Polastri M, Pehlivan E, Reed RM. Inspiratory Muscle Training for Lung Transplant Candidates and Recipients. EXP CLIN TRANSPLANT 2024; 22:479-486. [PMID: 39223806 DOI: 10.6002/ect.2024.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVES Inspiratory muscle training is used in rehabilitation to exercise respiratory muscles in various conditions associated with limited ventilatory reserve. In this review, we investigated inspiratory muscle training in lung transplant candidates and recipients. MATERIALS AND METHODS We searched 5 primary databases from inception through April 2024. Two key word entries, "lung transplantation" and "inspiratory muscle training," 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 119 citations. Seven articles that considered 64 patients (47% female) were included in the final analysis, with 1 study involving a pediatric patient. Lung transplant recipients used a threshold trainer at 15% to 60% of maximal inspiratory pressure and mostly exercised twice daily for 10 to 15 minutes per session. Lung transplant candidates exercised at 30% to >50% of maximal inspiratory pressure twice daily, performing 30 to 60 inspirations or for 15 minutes. The highest inspiratory muscle strength was observed in a series of adult lung transplant recipients whose mean value improved by 31.8 ± 14.6 cmH2O versus baseline after treatment. To the same extent, the highest value of maximal inspiratory pressure was detected in a pediatric patient who scored 180 cmH2O after training. Overall, participants obtained improvements in lung function (forced expiratory volume in 1 second, forced vital capacity), functional performance, dyspnea intensity, and exercise tolerance. Inspiratory muscle training is easy to perform and can be done at home without specific supervision (in adults) before or after a lung transplant. Nevertheless, additional rigorous investigations should aim to replicate the positive effects reported in the present review.
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Affiliation(s)
- Massimiliano Polastri
- >From the Department of Continuity of Care and Integration, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Barbosa M, de Melo CA, Torres R. The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: a prospective cohort study. CANADIAN JOURNAL OF RESPIRATORY THERAPY : CJRT = REVUE CANADIENNE DE LA THERAPIE RESPIRATOIRE : RCTR 2024; 60:68-85. [PMID: 38828206 PMCID: PMC11144029 DOI: 10.29390/001c.117966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024]
Abstract
Introduction Pilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD. Methods Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes. Results There were no consistent statistically significant differences between groups for the lung function outcomes (p\<0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (p\<0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (p=0.005) and six and nine months for maximal expiratory pressure (p=0.027 and p\<0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (p>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (p\<0.05). Discussion Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles. Conclusion Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.
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Affiliation(s)
- Marisela Barbosa
- PhysiotherapyCentro Hospitalar do Baixo Vouga Aveiro - Unidade Local de Saúde da Região de Aveiro, Aveiro, Portugal
- PhysiotherapyEscola Superior de Saúde Norte da Cruz Vermelha Portuguesa, Oliveira de Azeméis, Portugal
| | - Cristina A. de Melo
- PhysiotherapySchool of Allied Health Technologies, Polytechnic Institute of Porto, Porto, Portugal (retired)
| | - Rui Torres
- PhysiotherapyCESPU, North Polytechnic Institute of Health, Paredes, Portugal
- PhysiotherapyCIR, Center for Rehabilitation Research, Polytechnic Institute of Porto, Porto, Portugal
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Huang CY, Hsieh MS, Hsieh PC, Wu YK, Yang MC, Huang SY, Tzeng IS, Lan CC. Pulmonary rehabilitation improves exercise capacity, health-related quality of life, and cardiopulmonary function in patients with non-small cell lung cancer. BMC Cancer 2024; 24:211. [PMID: 38360680 PMCID: PMC10870628 DOI: 10.1186/s12885-024-11977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/07/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Lung cancer significantly impairs exercise capacity and health-related quality of life (HRQL). Pulmonary rehabilitation (PR) has demonstrated positive effects on exercise capacity and HRQL in lung cancer patients. However, its impact on cardiopulmonary function needs further exploration. The aim of this study was to explore the effects of PR on cardiopulmonary function, exercise capacity and HRQL in patients with lung cancer. METHODS Patients with lung cancer were enrolled in a 12-week PR program. Each participant underwent a thorough evaluation, which included spirometry, cardiopulmonary exercise testing, respiratory muscle strength test, and evaluation of HRQL using the Chronic Obstructive Pulmonary Disease Assessment Test (CAT). RESULTS Fifty-six patients completed the PR program. Following PR, exercise capacity significantly improved, as evidenced by increased peak oxygen uptake and work rate (both p < 0.05). Exertional symptoms were notably reduced, including leg soreness and dyspnea at peak exercise, accompanied by a decrease in the CAT score (all p < 0.05). Furthermore, improvements in cardiopulmonary function were observed, encompassing respiratory muscle strength, ventilatory equivalent, tidal volume, stroke volume index, and cardiac index at peak exercise (all p < 0.05). CONCLUSIONS PR demonstrated notable enhancements in cardiopulmonary function, exertional symptoms, exercise capacity, and HRQL in patients with lung cancer.
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Affiliation(s)
- Chun-Yao Huang
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City, 23142, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Min-Shiau Hsieh
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Thoracic Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City, 23142, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City, 23142, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Shiang-Yu Huang
- Division of Respiratory Therapy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City, 23142, Taiwan.
- School of Medicine, Tzu Chi University, Hualien, Taiwan.
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Araújo BTS, Barros AEVR, Nunes DTX, Remígio de Aguiar MI, Mastroianni VW, de Souza JAF, Fernades J, Campos SL, Brandão DC, Dornelas de Andrade A. Effects of continuous aerobic training associated with resistance training on maximal and submaximal exercise tolerance, fatigue, and quality of life of patients post-COVID-19. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1972. [PMID: 36088642 PMCID: PMC9539049 DOI: 10.1002/pri.1972] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/24/2022] [Accepted: 08/28/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Dyspnea, fatigue, and reduced exercise tolerance are common in post-COVID-19 patients. In these patients, rehabilitation can improve functional capacity, reduce deconditioning after a prolonged stay in the intensive care unit, and facilitate the return to work. Thus, the present study verified the effects of cardiopulmonary rehabilitation consisting of continuous aerobic and resistance training of moderate-intensity on pulmonary function, respiratory muscle strength, maximum and submaximal tolerance to exercise, fatigue, and quality of life in post-COVID-19 patients. METHODS Quasi-experimental study with a protocol of 12 sessions of an outpatient intervention. Adults over 18 years of age (N = 26) with a diagnosis of COVID-19 and hospital discharge at least 15 days before the first evaluation were included. Participants performed moderate-intensity continuous aerobic and resistance training twice a week. Maximal and submaximal exercise tolerance, lung function, respiratory muscle strength, fatigue and quality of life were evaluated before and after the intervention protocol. RESULTS Cardiopulmonary rehabilitation improved maximal exercise tolerance, with 18.62% increase in peak oxygen consumption (VO2peak) and 29.05% in time to reach VO2 peak. VE/VCO2 slope reduced 5.21% after intervention. We also observed increased submaximal exercise tolerance (increase of 70.57 m in the 6-min walk test, p = 0.001), improved quality of life, and reduced perceived fatigue after intervention. DISCUSSION Patients recovered from COVID-19 can develop persistent dysfunctions in almost all organ systems and present different signs and symptoms. The complexity and variability of the damage caused by this disease can make it difficult to target rehabilitation programs, making it necessary to establish specific protocols. In this work, cardiopulmonary rehabilitation improved lung function, respiratory muscle strength, maximal and submaximal exercise tolerance, fatigue and quality of life. Continuous aerobic and resistance training of moderate intensity proved to be effective in the recovery of post-COVID-19 patients.
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Affiliation(s)
| | | | | | | | | | | | - Juliana Fernades
- Laboratory of Physiotherapy and Public HealthDepartment of PhysiotherapyFederal University of PernambucoRecifeBrazil
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Rodrigues VN, Andriollo DB, Cielo CA. Respiratory and Sound Pressures, Maximum Phonation Time, Cervical Disability and Voice-Related Quality of Life of Teachers. J Voice 2022:S0892-1997(22)00365-4. [PMID: 36543607 DOI: 10.1016/j.jvoice.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Many teachers report discomfort and a decrease in the quality of aerodynamic, respiratory, and cervical vocal aspects as well as of vocal self-assessment. OBJECTIVE Characterize and correlate measurements of Sound Pressure Levels, Maximum Phonation Time of /a/, Maximum Respiratory Pressures, Voice-Related Quality of Life and cervical pain in teachers with vocal and musculoskeletal complaints and no organic vocal fold lesions, and compare with normative values. METHODS Retrospective study with 56 teachers. Anamnesis, video laryngoscopy, hearing screening, measurements of sound pressure and maximum phonation time, and manovacuometry were performed. Self-assessment protocols for Voice-Related Quality of Life and Neck Disability Index were completed. RESULTS there was significant higher Sound Pressure Levels; significant lower Maximum Phonation Time of /a/, Maximum Expiratory Pressure, and total and physical scores of Voice-Related Quality of Life; most participants had mild cervical disability; there was a negative correlation between Maximum Expiratory Pressure and Neck Disability Index, between Maximum Inspiratory Pressure and Maximum Sound Pressure Level, and between Neck Disability Index and Voice-Related Quality of Life. CONCLUSION The results showed that there are damages and inadequacies in teachers' vocal production which affect their quality of life. Therefore, it is necessary to pay attention to the conditions of use of the voice by professionals, and to their health education.
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Affiliation(s)
- Viviane Nunes Rodrigues
- Departamento de Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Débora Bonesso Andriollo
- Departamento de Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Carla Aparecida Cielo
- Departamento de Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Huang CY, Hsieh MS, Wu YK, Hsieh PC, Yang MC, Tzeng IS, Lan CC. Chronic obstructive pulmonary disease assessment test for the measurement of deterioration and recovery of health status of patients undergoing lung surgery. Thorac Cancer 2022; 13:613-623. [PMID: 34989126 PMCID: PMC8841704 DOI: 10.1111/1759-7714.14306] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/27/2022] Open
Abstract
Background Patients with early lung cancer often undergo surgery. However, surgery usually results in a decline in health‐related quality of life (HRQL). Several questionnaires have previously been used to assess HRQL but some are impractical for clinical use. The chronic obstructive pulmonary disease assessment test (CAT) is simple and has been widely used in respiratory diseases but not for lung cancer. We therefore conducted this study to clarify the role of the CAT in postoperative deterioration and recovery of HRQL. Methods Fifty‐five patients who underwent lung resection were recruited into the study. Cardiopulmonary exercise tests and respiratory muscle strength were performed 1 week before surgery (pre‐OP) and at post‐OP 1 month. HRQL was assessed through the CAT and European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ‐C30) 1 week pre‐OP and post‐OP 1 and at 2 months. Results Fifteen (27.3%) patients underwent wedge resection, four (7.3%) underwent segmentectomy, and 36 (65.5%) underwent lobectomy. After lobectomy, exercise capacity decreased significantly. The deterioration of CAT symptoms (cough, phlegm, chest tightness, dyspnea, activity, confidence, sleep disturbance, and lack of energy) was more prominent in patients who had undergone lobectomy than wedge resection. Based on the EORTC QLQ‐C30, physical, role function, fatigue, pain, sleep disturbance, dyspnea, and global health status worsened significantly, whereas there was no significant difference in other symptoms. HRQL recovered at post‐OP 2 months in patients who had undergone wedge resection but not lobectomy. Conclusions Postoperative HRQL and exercise capacity in patients were significantly reduced, especially those who had undergone lobectomy. The CAT significantly reflected postoperative changes in HRQL.
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Affiliation(s)
- Chun-Yao Huang
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Min-Shiau Hsieh
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Thoracic Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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The effects of 6 weeks home rehabilitation program for non-ventilated COVID-19 patients after discharge: A case report. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.922882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Shen Y, Ru W, Huang X, Chen S, Yan J, Yang Z, Cai G. Impact of chronic respiratory diseases on re-intubation rate in critically ill patients: a cohort study. Sci Rep 2021; 11:8663. [PMID: 33883614 PMCID: PMC8060362 DOI: 10.1038/s41598-021-88007-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/26/2021] [Indexed: 01/18/2023] Open
Abstract
Chronic respiratory diseases’ (CRDs) impact on re-intubation rate remains unclear. We investigated the association between these factors in mechanically ventilated patients. Data were extracted from the freely available online Medical Information Mart for Intensive Care III database. CRDs were defined according to ICD-9 codes. Generalised linear regression and propensity score matching were performed. Of 13,132 patients, 7.9% required re-intubation. Patients with chronic obstructive pulmonary disease (COPD) had higher re-intubation (OR 2.48, 95% CI 1.83–3.33) and mortality rates (OR 1.64, 95% CI 1.15–2.34) than those without. Patients with asthma had a lower mortality rate (OR 0.63, 95% CI 0.43–0.92) but a similar re-intubation rate to those of patients without. These findings remained stable after propensity score matching and bootstrapping analysis. The association of COPD with re-intubation was significantly stronger in patients with high oxygen-partial pressure (PaO2) or mild disease severity but was independent of carbon dioxide partial pressure. Corticosteroid use was associated with increased re-intubation rates in subgroups without CRDs (OR 1.77–1.99, p < 0.001) but not in subgroups with CRDs. COPD patients with high post-extubation PaO2 or mild disease severity should be carefully monitored as they have higher re-intubation and mortality rates.
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Affiliation(s)
- Yanfei Shen
- Department of Intensive Care, Zhejiang Hospital, No. 12, Lingyin Road, Hangzhou, 322100, Zhejiang, People's Republic of China
| | - Weizhe Ru
- Department of Oncology, Cixi People's Hospital, Cixi, 315300, Zhejiang, People's Republic of China
| | - Xinmei Huang
- ENT Department, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, People's Republic of China
| | - Shangzhong Chen
- Department of Intensive Care, Zhejiang Hospital, No. 12, Lingyin Road, Hangzhou, 322100, Zhejiang, People's Republic of China
| | - Jing Yan
- Department of Intensive Care, Zhejiang Hospital, No. 12, Lingyin Road, Hangzhou, 322100, Zhejiang, People's Republic of China
| | - Zhouxin Yang
- Department of Intensive Care, Zhejiang Hospital, No. 12, Lingyin Road, Hangzhou, 322100, Zhejiang, People's Republic of China.
| | - Guolong Cai
- Department of Intensive Care, Zhejiang Hospital, No. 12, Lingyin Road, Hangzhou, 322100, Zhejiang, People's Republic of China.
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