Pulmonary - Lung transplant Flashcards
Who qualifies for a lung transplant?
- if they have progressive terminal cardiopulm diseease and will die soon
- with emphysema
What are the indicators for lung transplant?
COPD
idiopathic pulmonary fibrosis
CF
idiopathic pulmonary arterial HTN
Sarcoidosis
What is the survical rate post 1 year transplant?
greater than 80%
What is the survival rate after 5 years?
~ 50%
What is the % of being able to perform physical activity?
80% with minimal limitations
What is the evaluation needed for lung transplant?
- needed to be on the list
- medical compliance with social support
- consider styles of coping with stressors
- caregiver stress
What is the pre-operative rehab?
A picture
What is a major-long term complication of lung transplant?
brochiolitis obliterans syndrome (BOS) = fibrosing of the terminal bronchioles
What are the sx of BOS?
- dyspnea
- limited exercise tolerance
- productive cough with sputum
What are the clinical presentation of BOS?
decreased breath sounds
crackles and rales
pulmonary HTN
What is the treatment for BOS?
prevention through maintenance of immunosuppression drug regimen
quickly intervening to treat infections or rejections
What are the problems present in the early stages of lung transplant?
- decreased mucus clearance
- ineffective cough
due to denervation
What are the initial PT management goals?
improve functional abilities, self-care and mobility
- bronchial hygiene
- positioning
- enhance cough effort
- mobility
Activity levels for inpatient PT
Guidelines for determining appropriateness of exercise and progression
What is the process of lung volume reduction surgery?
20-30% of volume of each lung is removed
What is the goal of lung volume reduction surgery?
improve thoracic distention and chest wall mechanism
What is lung-volume reduction surgery common for?
Severe COPD
emphysema
What is the mechanism of non-invasive ventilation or BiPAP
A mask that deliever positive airway pressure during inhalation/exhalation
BiPAP is used due to the indication of what?
With respiratory failure and not responding to max meds/O2 therapy
What is BiPAP commonly used for?
for severe COPD
- because of increased sx at night = cyclic pattern of no sleep -> daytime fatigue
What can BiPAP also be used for?
For emergent flare-ups to reduce load off breathing and heart
