Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz – Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm. Fizjoterapia Polska 2001; 1(3); 292-296

Abstract

The purpose of this article is to present the case of a patient with the Marfan syndrome who underwent surgery to repair an aortal aneurysm and his early rehabilitation, with particular emphasis on respiratory therapy. A 32-year-old patient with the Marfan syndrome was admitten to the Cardiovascular Surgery and Transplantology Clinic at the Jagiellonian University’s Collegium Medicum in Cracow, Poland, with suspected delamination of an aneurysm in the ascending aorta. Computer tomography revealed supravalvular dilatation of the ascending aorta along a 5-6 cm segment. Emergency surgery was performed using the Bental de Bono Composite Graft St. Jude Medical 25A method and ingrafting a venous bypass to the RCA. After surgery the patient was “suppressed” for 7 days in a drug-induced coma (low arterial blood pressure must be maintained initially in a patient with a surgically implanted prosthesis to prevent damage to the graft site). On the 8th day an attempt was made to extubate the patient. After ca. 14 hours of spontaneous respirator the patient was reintubed due to respiratory and circulatory insufficiency. On the 13th day when it proved impossible to terminate mechanical ventilation of the patient, a tracheotomy was performed. On the 19th day a successful effort was made to disconnect the patient from the respirator. At present the patient is breathing independently and is undergoing rehabilitation in the Department of Surgery. The article describes the program of early rehabilitation for this patient. The significance of the case for physiotherapy practice will be discussed.

Key words:
mechanical ventilation, Rehabilitation, Marfan Syndrome
Invalid download ID. Pobierz bezpłatnie artykuł w j. angielskim