Removing “Another Brick in the Wall”: Pulmonary Rehabilitation of a Patient with Very Severe COPD during Hospitalization
Remoção de Obstáculos: Reabilitação Respiratória de um Doente com DPOC Muito Severa durante o Internamento
DOI:
https://doi.org/10.60591/crspmi.235Keywords:
Hospitalization, Pulmonary Disease, Chronic Obstructive/rehabilitationAbstract
Pulmonary rehabilitation is fundamental for chronic obstructive pulmonary disease. However, few patients complete the intervention, and enrolling during hospitalization needs consideration.
We report the case of a 72-year-old male patient, with
very severe chronic obstructive pulmonary disease, presented with aggravated dyspnea, fatigue, hemoptysis and shivering. Chest radiograph showed a round opacity, with air-fluid level, suggestive of lung abscess. The patient was hospitalized and began treatment with oxygen and piperacillin-tazobactam. The lack of response led to escalation of therapy with meropenem and linezolid. The patient showed favorable response and a supervised pulmonary rehabilitation program was started. At discharge, after 7 weeks of hospitalization, he showed resolution of lung abscess and improved dyspnea, anxiety, depression, autonomy, and oxygen requirements compared to its baseline.
In this work, the authors present the significant benefits of implementing a pulmonary rehabilitation program during hospitalization.
Downloads
References
Morgan MD, Caverley PM, Clark CJ, Davidson AC, Garrod E, Goldman JM, et al. British Thoracic Society Standards of Care Subcommittee on Pulmonary Rehabilitation: Pulmonary rehabilitation. Thorax. 2001;56:827-34. doi: 10.1136/thorax.56.11.827.
Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:e13-64. doi: 10.1164/rccm.201309-1634ST.
Holland AE, Cox NS, Houchen-Wolloff L, Rochester CL, Garvey C, Zu-Wallack R, et al. Defining Modern Pulmonary Rehabilitation. An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc. 2021;18:e12-e29. doi: 10.1513/AnnalsATS.202102-146ST.
McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2015:CD003793. doi: 10.1002/14651858. CD003793.pub3.
Jones SE, Barker RE, Nolan CM, Patel S, Maddocks M, Man WDC. Pulmonary rehabilitation in patients with an acute exacerbation of chronic obstructive pulmonary disease. J Thorac Dis. 2018;10:S1390-9. doi: 10.21037/jtd.2018.03.18.
Lu HY, Chen CF, Lee DL, Tsai YJ, Lin PC. Effects of Early Pulmonary Rehabilitation on Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Int J Chron Obstruct Pulmon Dis. 2023;18:881-93. doi: 10.2147/COPD.S397361.
Lindenauer PK, Stefan MS, Pekow PS, Mazor KM, Priya A, Spitzer KA, et al. Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries. JAMA. 2020;323:1813-23. doi: 10.1001/jama.2020.4437.
Machado A, Oliveira A, Valente C, Burtin C, Marques A. Effects of a community-based pulmonary rehabilitation programme during acute exacerbations of chronic obstructive pulmonary disease - A quasi-experimental pilot study. Pulmonology. 2020;26:27-38. doi: 10.1016/j.pulmoe.2019.05.004.
Blervaque L, Préfaut C, Forthin H, Maffre F, Bourrelier M, Héraud N, et al. Efficacy of a long-term pulmonary rehabilitation maintenance program for COPD patients in a real-life setting: a 5-year cohort study. Respir Res. 2021;22:79. doi: 10.1186/s12931-021-01674-3.
Kuhajda I, Zarogoulidis K, Tsirgogianni K, Tsavlis D, Kioumis I, Kosmidis C, et al. Lung abscess-etiology, diagnostic and treatment options. Ann Transl Med. 2015;3:183. doi: 10.3978/j.issn.2305-5839.2015.07.08.
Stefan MS, Pekow PS, Priya A, ZuWallack R, Spitzer KA, Lagu TC, et al. Association between initiation of pulmonary rehabilitation and rehospitalizations in patients hospitalized with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2021;204:1015-23. doi: 10.1164/rccm.202012-4389OC.
Venkatesan P. GOLD COPD report: 2023 update. Lancet Respir Med. 2023;11:18. doi: 10.1016/S2213-2600(22)00494-5.
Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016;12:CD005305. doi: 10.1002/14651858.CD005305.pub4.
Du Y, Lin J, Wang X, Zhang Y, Ge H, Wang Y, et al. Early pulmonary rehabilitation in acute exacerbation of chronic obstructive pulmonary disease: a meta-analysis of randomized controlled trials. COPD. 2022;19:69-80. doi: 10.1080/15412555.2022.2029834.
Jones SE, Green SA, Clark AL, Dickson MJ, Nolan AM, Moloney C, et al. Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: referrals, uptake and adherence. Thorax. 2014;69:181-2. doi: 10.1136/thoraxjnl-2013-204227.
Spruit MA, Singh SJ, Rochester CL, Greening NJ, Franssen FM, Pitta F, et al. Pulmonary rehabilitation for patients with COPD during and after an exacerbation-related hospitalisation: back to the future? Eur Respir J.2018;51:1701312. doi: 10.1183/13993003.01312-2017.
Loukeri AA, Kampolis CF, Tomos P, Papapetrou D, Pantazopoulos I, Tzagkaraki A, et al. Diagnosis, treatment and prognosis of lung abscess. Pneumon. 2015;1:54-60.
Magalhães L, Valadares D, Oliveira JR, Reis E. Lung abscesses: review of 60 cases. Rev Port Pneumol. 2009;15:165-78.
Corhay JL, Dang DN, Van Cauwenberge H, Louis R. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy. Int J Chron Obstruct Pulmon Dis. 2014;9:27-39. doi: 10.2147/COPD.S52012.
Downloads
Published
How to Cite
License
Copyright (c) 2024 Bruno Cabrita, Cláudia Santos, Sónia Silva, Eva Gonçalves, Raquel Oliveira
This work is licensed under a Creative Commons Attribution 4.0 International License.
