Pub Date : 2024-01-01DOI: 10.1016/S2659-6636(24)00072-9
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Pub Date : 2024-01-01DOI: 10.1016/j.opresp.2023.100288
Laura Muelas-Gómez , Lara Martínez-Gimeno , Cristina Escudero-Gómez , María Ángeles Atin Arratibel , Maria Angels Cebrià i Iranzo , Montserrat Solís-Muñoz
Introduction
Respiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period.
Methodology
A systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: “breathing exercise”, “respiratory muscle training”, “inspiratory muscle training”, “respiratory exercise”, “pulmonary rehabilitation”, “lung rehabilitation”; in combination with “lung transplantation”, “lung transplant”, “posttransplant lung”. No language limit.
Results
Eleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test.
Conclusions
Training the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.
{"title":"Eficacia de las intervenciones fisioterápicas sobre la musculatura respiratoria mediante técnicas de entrenamiento respiratorio en el postoperatorio de trasplantados pulmonares: una revisión sistemática","authors":"Laura Muelas-Gómez , Lara Martínez-Gimeno , Cristina Escudero-Gómez , María Ángeles Atin Arratibel , Maria Angels Cebrià i Iranzo , Montserrat Solís-Muñoz","doi":"10.1016/j.opresp.2023.100288","DOIUrl":"10.1016/j.opresp.2023.100288","url":null,"abstract":"<div><h3>Introduction</h3><p>Respiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period.</p></div><div><h3>Methodology</h3><p>A systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: “breathing exercise”, “respiratory muscle training”, “inspiratory muscle training”, “respiratory exercise”, “pulmonary rehabilitation”, “lung rehabilitation”; in combination with “lung transplantation”, “lung transplant”, “posttransplant lung”. No language limit.</p></div><div><h3>Results</h3><p>Eleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test.</p></div><div><h3>Conclusions</h3><p>Training the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.</p></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"6 1","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2659663623000747/pdfft?md5=01abd9c892f1aab0415f67c4797361fb&pid=1-s2.0-S2659663623000747-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.opresp.2023.100290
Javier Lázaro Sierra , Miranda Doz Arcas , Paloma Clavería Marco , M. Teresa Rosell Abos , Miguel Angel Santolaria López , Laura Pérez Gimenez , Teresa Lanzuela Benedicto , Marcos Zuil Martin , Ana Boldova Loscertales , Sandra García Saez , Ana Huertas Puyuelo , David Nieto Sánchez , José Angel Carretero García
Introduction
COVID-19 pneumonia results in an impairment of the diaphragmatic musculature that influences the development of respiratory failure during the patient's hospitalization. Diaphragmatic ultrasound is a useful, non-invasive, and accessible tool for measuring the function of this muscle.
Objective
Assessing the morphological and functional ultrasound status of the diaphragm in patients admitted within the first 24 h for COVID-related pneumonia and its association with hospital morbidity and mortality (NCT05805579).
Material and methods
Observational, prospective cohort study that included 68 patients admitted for COVID-19 pneumonia with respiratory failure. Diaphragmatic ultrasound was performed within the first 24 h of admission to the pulmonology ward. Clinical, analytical, and ultrasound variables were collected: excursion, thickness, and diaphragmatic shortening fraction (DSF). DSF < 20% was used to define diaphragmatic dysfunction (DD). Patients who showed favorable progression and were managed on the ward (HCONV) were compared to those who required admission to the respiratory monitoring unit (RMU).
Results
A total of 68 patients were included, of which 22 (32.35%) were admitted to the RMU. Diaphragmatic excursion at maximum volume was higher in the HCONV group compared to the RMU group (58.41 ± 17.83 vs. 50.03 ± 16.23; p = 0.123). Diaphragmatic dysfunction (DD) was observed in 21 (30.88%) patients, with a higher prevalence in the RMU group than in the HCONV group (15 (68.18%) vs. 6 (13.04%); p = 0.0001). In the multivariate analysis, age and DSF at admission were the best predictors of failure to discharge.
Conclusions
Performing diaphragmatic ultrasound to assess mobility and DSF within the first 24 h of admission for COVID-19 pneumonia proves valuable in determining short-term progression and the need for admission to a respiratory monitoring unit.
{"title":"Prognostic Value of Diaphragmatic Ultrasound in Patients Admitted for COVID-19 Pneumonia","authors":"Javier Lázaro Sierra , Miranda Doz Arcas , Paloma Clavería Marco , M. Teresa Rosell Abos , Miguel Angel Santolaria López , Laura Pérez Gimenez , Teresa Lanzuela Benedicto , Marcos Zuil Martin , Ana Boldova Loscertales , Sandra García Saez , Ana Huertas Puyuelo , David Nieto Sánchez , José Angel Carretero García","doi":"10.1016/j.opresp.2023.100290","DOIUrl":"10.1016/j.opresp.2023.100290","url":null,"abstract":"<div><h3>Introduction</h3><p>COVID-19 pneumonia results in an impairment of the diaphragmatic musculature that influences the development of respiratory failure during the patient's hospitalization. Diaphragmatic ultrasound is a useful, non-invasive, and accessible tool for measuring the function of this muscle.</p></div><div><h3>Objective</h3><p>Assessing the morphological and functional ultrasound status of the diaphragm in patients admitted within the first 24<!--> <!-->h for COVID-related pneumonia and its association with hospital morbidity and mortality (<span>NCT05805579</span><svg><path></path></svg>).</p></div><div><h3>Material and methods</h3><p>Observational, prospective cohort study that included 68 patients admitted for COVID-19 pneumonia with respiratory failure. Diaphragmatic ultrasound was performed within the first 24<!--> <!-->h of admission to the pulmonology ward. Clinical, analytical, and ultrasound variables were collected: excursion, thickness, and diaphragmatic shortening fraction (DSF). DSF<!--> <!--><<!--> <!-->20% was used to define diaphragmatic dysfunction (DD). Patients who showed favorable progression and were managed on the ward (HCONV) were compared to those who required admission to the respiratory monitoring unit (RMU).</p></div><div><h3>Results</h3><p>A total of 68 patients were included, of which 22 (32.35%) were admitted to the RMU. Diaphragmatic excursion at maximum volume was higher in the HCONV group compared to the RMU group (58.41<!--> <!-->±<!--> <!-->17.83 vs. 50.03<!--> <!-->±<!--> <!-->16.23; <em>p</em> <!-->=<!--> <!-->0.123). Diaphragmatic dysfunction (DD) was observed in 21 (30.88%) patients, with a higher prevalence in the RMU group than in the HCONV group (15 (68.18%) vs. 6 (13.04%); <em>p</em> <!-->=<!--> <!-->0.0001). In the multivariate analysis, age and DSF at admission were the best predictors of failure to discharge.</p></div><div><h3>Conclusions</h3><p>Performing diaphragmatic ultrasound to assess mobility and DSF within the first 24<!--> <!-->h of admission for COVID-19 pneumonia proves valuable in determining short-term progression and the need for admission to a respiratory monitoring unit.</p></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"6 1","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2659663623000760/pdfft?md5=c311c3781db9c86ce5eb73c6a94036b8&pid=1-s2.0-S2659663623000760-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138613379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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