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  • Subject Name : Medical Sciences

Cystic Fibrosis

Lung transplant in the patients with cystic fibrosis requires setting of short term and long term goals. Following the lung transplant there is a requirement of respiratory management, functional rehabilitation, education and physical rehabilitation (Hayes et al., 2012). After the Lung transplantation, physiotherapy and respiratory therapy plays very important role in bringing back the patient to normal life and functioning. It assists in improving the elimination of secretions in the post- operative phase of the patient. It also counteracts the limited ventilation due to thoracic restrictions and the contractures that are associated with pain. It starts is ICU setting where early mobilization is aimed. The benefit of post- operative rehabilitation in the patients with lung transplantation leads to decreased dyspnea and subjectively improved general condition (Hirche et al., 2014).

The rehabilitation also helps in improving the patient’s quality of life and this can be best accomplished by endurance of the patient and strength training. Pulmonary rehabilitation and physical therapy cumulatively assists the patient in coming back to the normal living. This pulmonary rehabilitations assists the individual in improving the physical fitness that makes the achieve the maximum benefit from the new lungs. The post- operative rehabilitation aims to clear the pulmonary secretion on the first post- operative day and facilitates an active cough that is crucial for secretion removal. The patient’s rehabilitation after the exit from ICU focuses on alveolar ventilation and mucociliary transport. The essential components are breathing control, airway clearance technique, mobilization and coughing maneuvers (Kenn et al., 2015). This helps the patient in improving ambulation distance and their participation in daily life activities.

The physical therapy is also continued along with patient’s rehabilitation sessions that aims to achieve goals such as independent secretion clearance, independence in daily based activities, improved ventilation and improved thoracic mobility. The breathing exercises are included in the thoracic mobility and cardiovascular exercise regime.

All of these together assists the patient in returning to normal life and normal duties. This enhances their quality of life and ensures physical and emotional well- being of the patients who have undergone lung transplant due to cystic fibrosis (Snell, Reed, Stern & Hadjiliadis, 2017).

References

Hayes Jr, D., Kukreja, J., Tobias, J. D., Ballard, H. O., & Hoopes, C. W. (2012). Ambulatory venovenous extracorporeal respiratory support as a bridge for cystic fibrosis patients to emergent lung transplantation. Journal of Cystic Fibrosis, 11(1), 40-45.

Hirche, T. O., Knoop, C., Hebestreit, H., Shimmin, D., Solé, A., Elborn, J. S., ... & Ecorn-Cf Study Group. (2014). Practical guidelines: lung transplantation in patients with cystic fibrosis. Pulmonary Medicine, 2014.

Kenn, K., Gloeckl, R., Soennichsen, A., Sczepanski, B., Winterkamp, S., Boensch, M., & Welte, T. (2015). Predictors of success for pulmonary rehabilitation in patients awaiting lung transplantation. Transplantation, 99(5), 1072-1077.

Snell, G., Reed, A., Stern, M., & Hadjiliadis, D. (2017). The evolution of lung transplantation for cystic fibrosis: a 2017 update. Journal of Cystic Fibrosis, 16(5), 553-564.

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