Carolyn L Rochester MD
Introduction Rationale for Pulmonary Rehabilitation Prior to LungVolume Reduction Surgery or Lung Transplantation Benefits of Pulmonary Rehabilitation Prior to LVRS or Lung Transplantation Clinical Benefits of Pulmonary Rehabilitation Versus LVRS PulmonaryRehabilitation Following LVRS or Lung Transplantation Program Content of Pulmonary Rehabilitation for LVRS or Lung Transplantation Summary Patients preparing for or recovering from lung-volume-reduction surgery(LVRS) or lung transplantation represent a selected group of patients with advanced chronic respiratory disease. Such patients typically have severe ventilatory limitation and disability and are athigh risk of preoperative and postoperative complications. Pulmonary rehabilitation is an ideal setting in which to: address the patient’s questions and knowledge-deficits regarding his or her diseaseand its treatment; ensure that the patient understands the nature, potential benefits, risks, and expected outcomes of the surgery relative to medical therapies, and; prepare physically andemotionally for the surgery. Pulmonary rehabilitation also may improve survival to and/or outcomes of LVRS and transplantation, at least in part by stabilizing and improving the patient’s exercise tolerance andmuscle function. Further work is needed to determine whether pulmonary rehabilitation can augment the benefits and outcomes of LVRS or lung transplantation, reduce postoperative complications, orimprove patient survival to or following the surgery. Key words: lung-volume-reduction surgery, LVRS, lung transplantation, chronic respiratory disease, pulmonary rehabilitation. [Respir Care2008;53(9):1196 –1202. © 2008 Daedalus Enterprises]
Introduction Pulmonary rehabilitation is now recognized widely as an important component of care of patients with chronic
obstructive pulmonary disease...