Ann Transl Med . Early rehabilitation after lung transplantation with extracorporeal membrane oxygenation (ECMO) of COVID-19 patient: a case report

[tetano]

Ann Transl Med


. 2021 Mar;9(6):512.
doi: 10.21037/atm-21-456.
Early rehabilitation after lung transplantation with extracorporeal membrane oxygenation (ECMO) of COVID-19 patient: a case report


Lin Mao ¹ , Lunjie Luo ¹ , Daming Wang ¹ , Ying Yu ¹ , Shihao Dong ¹ , Pu Zhang ¹ , Yun Sun ¹ , Zuobing Chen ¹



Affiliations

• PMID: 33850909
• PMCID: PMC8039682
• DOI: 10.21037/atm-21-456

Abstract

Even when severe acute respiratory syndrome coronavirus 2-related coronavirus disease 2019 (COVID-19) is treated with first-line drugs, it progresses and leads to irreversible loss of lung function in some critically ill patients, and lung transplantation is an effective treatment for end-stage chronic pulmonary disease. This case report mainly describes the rehabilitation of a 66-year-old female patient with severe COVID-19 after bilateral lung transplantation. The old patient had a body mass index of 31.2 kg/m². She underwent bilateral lung transplantation due to severe and irreversible injury of both lungs. Long-term mechanical ventilation and extracorporeal membrane oxygenation (ECMO) treatment and preoperative and postoperative high-dose corticosteroid therapy and due to the size of the donor lung does not match the size of the recipient's diseased lung, and the right middle lobe of the graft is removed before transplantation. Weaning from the ventilator failed due to weak neuromuscular drive, and muscle strength. A full, personalized pulmonary rehabilitation program was initiated with the help of the physical therapists, the respiratory therapy, the doctors, the nurses and psychotherapist team based on the functional levels. The rehabilitation intervention was conducted on postoperative day 4, This included posture management, airway clearance techniques, respiratory training, muscle strength training, transfer training, daily therapeutic bronchoscopy and psychological support. The ECMO was removed successfully on the fifth day. the patient's physical function, muscle strength and the quality of life has been improved. The good prognosis after rehabilitation indicates that early rehabilitation intervention is effective and feasible and safety for patients after lung transplantation.

Keywords: Coronavirus disease 2019 (COVID-19); case; early rehabilitation; lung transplantation.