The aim of this study is to present the effects of the medical team’s therapy with particular focus on early physiotherapy in a patient subjected to elective pneumonectomy due to pleural empyema and chest fenestration. Our patient was 48 years old and underwent an elective pneumonectomy due to pleural empyema and cicatrization atelectasis as a result of complications. A lack of lung recoil after chest fenestration was the indication to transfer the patient to the intensive care unit (ICU) from the operating theater. Respective rehabilitation is necessary to restore the function of the respiratory system. It should be an integral part of the treatment plan, must be implemented in a timely manner, and should continue until the patient’s full recovery. This paper presents the effects of the medical team’s work with the emphasis on early physiotherapy in a patient in the ICU that resulted in a shorter hospitalization and a full return to functional capacity.
StreszczenieCel pracy: Ocena przydatności testu sprawności fizycznej Fullerton u pacjentów kwalifikowanych do zabiegów torakochirurgicznych. Materiał i metody: Badaniem objęto 35 pacjentów w wieku 60-70 lat (średnia wieku 66,8 roku), w tym 17 kobiet i 18 męż-czyzn. Sprawność fizyczną oceniano za pomocą testu Fullerton dla osób starszych, opracowanego przez Roberta E. Rikli i C. Jessie Jones (Rikli & Jones). Wyniki: Test Fullerton był dobrze tolerowany przez pacjentów torakochirurgicznych. W trakcie badania i bezpośrednio po nim nie odnotowano uczucia duszności, omdleń, spadku saturacji ani pogorszenia samopoczucia chorych. U większości pacjentów wykazano poprawę wartości spirometrycznych (VC% o 20%, FEV 1 %VC o 22%). Zanotowano wzrost skurczowego ciśnienia tętniczego (50-80%) i przyspieszenie akcji serca (77-90%) ocenianych po najcięższych próbach określających wytrzymałość tlenową oraz wytrzymałość siłową górnej i dolnej części ciała. Wnioski: Test Fullerton może być bezpiecznie stosowany u pacjentów kwalifikowanych do zabiegów torakochirurgicznych. Jako nowa, powtarzalna metoda badawcza może stanowić uzupełnienie kompleksowej diagnostyki chorych przygotowywanych do zabiegu chirurgicznego. Słowa kluczowe: rehabilitacja oddechowa, resekcja miąższu, test Fullerton. REHABILITATION AbstractAim: To evaluate physical fitness with the Fullerton test in patients referred for thoracic procedures. Material and methods: The study included 35 patients aged 60-70 years (mean 66.8 years): 17 women and 18 men. Physical fitness was assessed using a test for the elderly (Fullerton Rikli & Jones). Results: The Fullerton test was well tolerated by thoracic surgery patients. During the study, and immediately afterwards, there was no shortness of breath, fainting, loss of saturation or deterioration of well-being of patients. Most patients showed an improvement in spirometric values (vital capacity -VC% to 20%, forced expiratory volume in one second % of vital capacity -FEV 1 %VC of 22%). There was a positive hemodynamic response in systolic blood pressure (50-80%) and heart rate (77-90%) rated the most serious attempts to determine aerobic endurance and strength endurance of the upper and lower body. Conclusions: The Fullerton test can be safely used in patients referred for thoracic procedures. As a new, reproducible method of testing, it can complement the comprehensive diagnosis of patients undergoing surgery.
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