Pulmonary rehabilitation

An integrated approach of health maintenance (e.g., smoking cessation), drug therapy, and supplemental therapy (e.g., oxygen and pulmonary rehabilitation) should be used in a stepwise manner. 

Pulmonary rehabilitation results in significant and clinically meaningful improvements in dyspnea, exercise capacity, health status, and health care utilization.10 It should be considered for patients with COPD who have dyspnea or other respiratory symptoms, reduced exercise capacity, a restriction in activities because of their disease, or impaired health status.1... 

Griffiths TL, Phillips CJ, Burr SD, et al. Cost effectiveness of an outpatient multidisciplinary pulmonary rehabilitation programme. Thorax 2001 56 779-84. 

Casaburi R et al Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD. Chest 2005 127 809. [PMID 15764761]... 

In addition to supplemental oxygen, adjunctive therapies to consider as part of a pulmonary rehabilitation program are psychoeducational care and nutritional support. Psychoeducational care (such as relaxation) has been associated with improvement in the functioning and well-being of adults with COPD."" The role of nutritional support in patients with COPD is controversial. Several studies have shown an association between malnutrition, low body mass index (BMI), and impaired pulmonary status among patients with COPD. However, in... 

Recent trials have evaluated the effect of bilateral lung volume reduction surgery (LVRS) for management of severe COPD. Short-term trials comparing the effects of pulmonary rehabilitation plus LVRS with pulmonary rehabihtation alone reported that the combination of treatments resulted in greater improvements in lung function, gas exchange, and quahty of life at 3 months. 

Heffner JE, Fahy B, Hilling L, Barbieri C. Outcomes of advanced directive education of pulmonary rehabilitation patients. Am J Respir Crit Care Med 1997 155 1055-1059. 

Respiratory Sensation, edited by L. Adams and A. Guz Pulmonary Rehabilitation, edited by A. P. Fishman Acute Respiratory Failure in Chronic Obstructive Pulmonary Disease, edited by J.-P. Derenne, W. A. Whiteiaw, and T. Simiiowski Environmental Impact on the Airways From Injury to Repair, edited by J. Chretien and D. Dusser... 

De Troyer A. Respiratory muscle function in chronic obstructive pulmonary disease. In Casaburi R, Petty YL, eds. Principles and Practice of Pulmonary Rehabilitation. Philadephia WB Saunders Company, 1993 33-49. 

Following implementation of the long-term phase of the rehabilitation framework, she was weaned and decannulated within 21 days. Her total LOS in the ICU was 106 days at a cost of 159,000 ( 301,221). She was transferred to the ward and went home 14 days later on an individual pulmonary rehabilitation program. At six months Sarah was back at work full time and has had no further physiological or psychological problems. Appendix 1 shows Sarah s specific rehabilitation and weaning plan. 

Pulmonary and Respiratory Intensive Care Unit-University Hospital Pisa, Italy and Pulmonary Rehabilitation and Weaning Center, Auxilium Vitae, Volterra (PI), Italy... 

Casaburi R. Deconditioning. In Fishman AP ed. Pulmonary Rehabilitation. New York Marcel Dekker, 1996 213-230. 

Troosters T, Casaburi R, Gosselink R, et al. Pulmonary rehabilitation in chronic obstructive pulmonary disease state of the art. Am J Respir Crit Care Med 2005 172 19-38. 

Wedzicha JA, Bestall JC, Garrod R, et al. Randomized controlled trial of pulmonary rehabilitation in severe COPD patients, stratified with the Medical Research Council Dyspnoea scale. Eur Respir J 1998 12 363-369. 

Nici L, Donner C, Wouters E, et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med 2006 173(12) 1390-1413. 

ACCP and AACVPR. Pulmonary Rehabilitation joint ACCP and AACVPR evidence-based guidelines. Chest 1997 112(5) 1363-1396. 

ZuWallack RE, Patel K, Reardon JZ, et al. Predictors of improvement in the 12-minute walk distance following a 6-week outpatient pulmonary rehabilitation program. Chest 1991 99 805-808. 

Plankeel JE, McMullen B, MacIntyre NR. Exercise outcomes after pulmonary rehabilitation depend on the initial mechanism of exercise limitation among non-oxygen-dependent COPD patients. Chest 2005 127 110-116. 

DeLisa J, Bach JR. Overview of rehabilitation, general evaluatiort, principles and the rehabilitation team. In JR Bach, ed. Pulmonary Rehabilitation. The Obstructive and Paralytic Conditions. Philadelphia Hanley Belfus, 1996 1-25. 

Robert D, Vitacca M. Ventilatory assistance at home. In Donner CF, Ambrosino N, Goldstein R, eds. Pulmonary Rehabilitation Efficacy and Scientific Basis. London Arnold, 2005 343-352. 

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