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Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach

World Journal of Transplantation 2016年第3期6卷 517-531页

作者： Lisa Wickerson Dmitry Rozenberg Tania Janaudis-Ferreira Robin Deliva Vincent Lo Gary Beauchamp Denise Helm Chaya Gottesman Polyana Mendes Luciana Vieira margaret herridge Lianne G Singer Sunita Mathur Toronto Lung Transplant Program University Health Network Rehabilitation Services University Health Network Department of Physical Therapy University of Toronto Rehabilitation Sciences Institute University of Toronto School of Physical and Occupational Therapy McGill University Canadian National Transplant Research Program Department of Physiotherapy Hospital for Sick Children Department of General Surgery/Gastroen- terology/Plastics St. Michael’s Hospital Health Sciences and Technologies PhD Program University of Brasilia Faculty of Medicine University of Toronto

Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgical interventions in lung transplantation have evolved over time, there has been a demographic shift of individuals undergoing lung transplantation including older individuals, those with multiple co-morbidites, and candidates with respiratory failure requiring bridging to transplantation. These changes have an impact on the rehabilitation needs of lung transplant candidates and recipients. This review provides a practical approach to rehabilitation based on research and clinical practice at our transplant centre. It focuses on functional assessment and exercise prescription during an uncomplicated and complicated clinical course in the pre-transplant, early and late post-transplant periods. The target audience includes clinicians involved in pre- and posttransplant patient care and rehabilitation researchers.

关键词： Lung transplantation Rehabilitation Physical therapy Exercise training Physical activity

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World Journal of Critical Care Medicine 2022年第4期11卷 236-245页

作者： Vincent Issac Lau Jeffrey A Johnson Sean M Bagshaw Oleksa G Rewa John Basmaji Kimberley A Lewis M Elizabeth Wilcox Kali Barrett Francois Lamontagne Francois Lauzier Niall D Ferguson Simon J W Oczkowski Kirsten M Fiest Daniel J Niven Henry T Stelfox Waleed Alhazzani margaret herridge Robert Fowler Deborah J Cook Bram Rochwerg Feng Xie Department of Critical Care Medicine University of AlbertaEdmonton T6G 2B7ABCanada School of Public Health Inst Hlth EconUniversity of AlbertaEdmonton T6G 2B7ABCanada Department of Medicine Division of Critical CareWestern UniversityLondon N6A 5W9Canada Division of Critical Care McMaster UniversityHamilton L8N 4A6Canada Interdepartmental Division of Critical Care University of TorontoToronto M5T 2S8Canada Department of Medicine University SherbrookeSherbrooke J1H 5N4Canada Departments of Medicine and Anesthesiology University LavalLaval G1V 4G2Canada Department Critical Care Medicine University of TorontoToronto M5G 2C4Canada Department of Medicine McMaster ClinHamilton Gen HospMcMaster UniversityHamilton L8N 4A6Canada Department of Community Health Sciences&Institute for Public Health University of CalgaryCalgary T2N 2T9Canada Department of Critical Care Medicine University CalgaryCalgary T2N 2T9Canada Department of Community Health Sciences University of CalgaryCalgary T2N 2T9Canada Department of Medicine McMaster UniversityHamilton L8N 4A6Canada Indepartmental Division of Critical Care University Health NetworkToronto M5G 2C4Canada Departments of Medicine and Critical Care Medicine Sunnybrook Health Sciences CenterInstitute of Health Policy Management and EvaluationUniversity of TorontoToronto M4N 3M5Canada Health Research Methods Evidence and ImpactMcMaster UniversityHamilton L8N 3Z5Canada

Mortality is a well-established patient-important outcome in critical care *** contrast,morbidity is less uniformly reported(given the myriad of critical care illnesses and complications of each)but may have a common end-impact on a patient’s functional capacity and health-related quality-of-life(HRQoL).Survival with a poor quality-of-life may not be acceptable depending on individual patient values and ***,as mortality decreases within critical care,it becomes increasingly important to measure intensive care unit(ICU)survivor *** measurements with a preference-based scoring algorithm can be converted into health utilities on a scale anchored at 0(representing death)and 1(representing full health).They can be combined with survival to calculate quality-adjusted life-years(QALY),which are one of the most widely used methods of combining morbidity and mortality into a composite *** QALYs have been use for health-technology assessment decision-making,an emerging and novel role would be to inform clinical decision-making for patients,families and healthcare providers about what expected HRQoL may be during and after ICU *** care randomized control trials(RCTs)have not routinely measured or reported HRQoL(until more recently),likely due to incapacity of some patients to participate in patient-reported outcome *** differences in HRQoL measurement tools can lead to non-comparable *** this end,we propose the validation of a gold-standard HRQoL tool in critical care,specifically the *** combined health-utility and mortality(disaggregated)and QALYs(aggregated)can be reported,with disaggregation allowing for determination of which components are the main drivers of the QALY *** use of HRQoL,health-utility,and QALYs in critical care RCTs has the potential to:(1)Increase the likelihood of finding important effects if they exist;(2)improve research efficiency;and(3)help inform optimal m

关键词： Critical care health-related quality of life Quality-adjusted life-years Health-utility Mortality Morbidity Kaplan-Meier curves

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