一位極重度慢性阻塞性肺疾患者之肺部復健介入整合照護經驗

Translated title of the contribution: Experiences of Pulmonary Rehabilitation in Integrated Care on a Patient with Very Severe COPD

何 淑娟(Shun-Chuan Ho), 郭 宏如(Hung-Ju Kuo), 吳 昭儀(Chao-Yi Wu), 江 玲玲(Ling-Ling Chiang), 陳 麗妃(Li-Fei Chen), 饒 文琴(Wen-Ching Jao), 施 崇鴻(Chung-Hung Shih)

Research output: Contribution to journalArticle

Abstract

This case was diagnosis as an patient with Gold moderately severe stage chronic obstructive pulmonary disease (COPD) when he was 51 years old, then he was deteriorated to Gold very severe stage at 55 years old and was first intubated. Afterward he quitted smoking and learn breathing control techniques, but continuing deterioration even persist intensive drug therapy, totally he was performed intubation three times between 2000 and 2007. He entered supervised endurance exercise training program by cell phone in a home setting at least for three months at 60 years old (2005), the outcomes of walking distance and quality of life significantly improved. At two and half years after rehabilitation, he was performed third intubation, difficulty weaning for persist hypercapnia was noted, so he was performed tracheotomy. During this ventilator dependent period, we found that the longer ventilator support, the worse hyperinflation, and then resulted more bullous emphysema change.
He was referred to bedside rehabilitation program in respiratory care center, it including intensive airway clearance, out of bed and limbs strengthening exercises. However he had worn ventilator for at least half a day, therefore he was transferred to respiratory care ward. He requested for home care, even the shortage of appropriate caregivers, he got better quality of life specially on emotional components at home setting. In this long term care process, there were two times intensive pulmonary rehabilitation interventions, one was at medical stable stage and he could breathing spontaneously, the other at subacute stage and ventilator dependent, we could found that he gained some improvement in activity of daily living and emotional support during both rehabilitation programs.
Translated title of the contributionExperiences of Pulmonary Rehabilitation in Integrated Care on a Patient with Very Severe COPD
Original languageTraditional Chinese
Pages (from-to)53-68
Number of pages16
Journal呼吸治療
Volume8
Issue number2
DOIs
Publication statusPublished - 2009

Keywords

  • Pulmonary rehabilitation
  • hyperinflation
  • Chronic obstructive pulmonary disease COPD

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