Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report
Objective: Severe mitral valve insufficiency may lead to heart failure and associated hemodynamic repercussions, such as congestion and weaning-induced pulmonary oedema. This slows weaning from mechanical ventilation, increases the length of the hospital stay, and worsens the patient's prognosi...
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Center for Scientific Research and Development of Education.
2018-08-01
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doaj-fbfad616540e4519a77821d1219001532020-11-25T01:58:27ZengCenter for Scientific Research and Development of Education.Heart Vessels and Transplantation1694-78861694-78942018-08-0123747810.24969/hvt.2018.73art73Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case reportLuiz Fernando Rodrigues JrCarla Cristiane Santos SoaresClaudia Rosa de OliveiraBeatriz Robert MoreiraMauro Felippe Felix MedianoJuliana Rega de OliveiraObjective: Severe mitral valve insufficiency may lead to heart failure and associated hemodynamic repercussions, such as congestion and weaning-induced pulmonary oedema. This slows weaning from mechanical ventilation, increases the length of the hospital stay, and worsens the patient's prognosis. Case report: The present report describes one strategy used for cardiopulmonary rehabilitation and to help wean a patient from mechanical ventilation, with prohibitive comorbidities that contra-indicate surgical mitral valve repair, using respiratory and peripheral muscle training associated with positive pressure ventilation. Discussion: The severe dysfunction of the mitral valve was considered to be surgically inoperable by the surgeon team. However, the weaning and rehabilitation challenges in this patient with severe chronic obstructive pulmonary disease, even with weaning-induced pulmonary edema occurrence, were overcome. The strategy to rehabilitate respiratory muscle force during positive pressure ventilation, concomitantly to a cardiopulmonary rehabilitation program, improved peripheral muscle strength and functionality, reducing energetic demand, allowing the weaning from mechanical ventilation. Conclusion: Despite the severity of the disease, with the adopted strategy it was possible to perform weaning of the mechanical ventilation, allowing the patient to survive with his relatives.https://hvt-journal.com/articles/art73weaning mechanical ventilation cardiopulmonary rehabilitation mitral insufficiency weaning-induced pulmonary edema |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Luiz Fernando Rodrigues Jr Carla Cristiane Santos Soares Claudia Rosa de Oliveira Beatriz Robert Moreira Mauro Felippe Felix Mediano Juliana Rega de Oliveira |
spellingShingle |
Luiz Fernando Rodrigues Jr Carla Cristiane Santos Soares Claudia Rosa de Oliveira Beatriz Robert Moreira Mauro Felippe Felix Mediano Juliana Rega de Oliveira Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report Heart Vessels and Transplantation weaning mechanical ventilation cardiopulmonary rehabilitation mitral insufficiency weaning-induced pulmonary edema |
author_facet |
Luiz Fernando Rodrigues Jr Carla Cristiane Santos Soares Claudia Rosa de Oliveira Beatriz Robert Moreira Mauro Felippe Felix Mediano Juliana Rega de Oliveira |
author_sort |
Luiz Fernando Rodrigues Jr |
title |
Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report |
title_short |
Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report |
title_full |
Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report |
title_fullStr |
Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report |
title_full_unstemmed |
Difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report |
title_sort |
difficulty in weaning and cardiopulmonary rehabilitation in inoperable severe mitral regurgitation: a case report |
publisher |
Center for Scientific Research and Development of Education. |
series |
Heart Vessels and Transplantation |
issn |
1694-7886 1694-7894 |
publishDate |
2018-08-01 |
description |
Objective: Severe mitral valve insufficiency may lead to heart failure and associated hemodynamic repercussions, such as congestion and weaning-induced pulmonary oedema. This slows weaning from mechanical ventilation, increases the length of the hospital stay, and worsens the patient's prognosis. Case report: The present report describes one strategy used for cardiopulmonary rehabilitation and to help wean a patient from mechanical ventilation, with prohibitive comorbidities that contra-indicate surgical mitral valve repair, using respiratory and peripheral muscle training associated with positive pressure ventilation. Discussion: The severe dysfunction of the mitral valve was considered to be surgically inoperable by the surgeon team. However, the weaning and rehabilitation challenges in this patient with severe chronic obstructive pulmonary disease, even with weaning-induced pulmonary edema occurrence, were overcome. The strategy to rehabilitate respiratory muscle force during positive pressure ventilation, concomitantly to a cardiopulmonary rehabilitation program, improved peripheral muscle strength and functionality, reducing energetic demand, allowing the weaning from mechanical ventilation. Conclusion: Despite the severity of the disease, with the adopted strategy it was possible to perform weaning of the mechanical ventilation, allowing the patient to survive with his relatives. |
topic |
weaning mechanical ventilation cardiopulmonary rehabilitation mitral insufficiency weaning-induced pulmonary edema |
url |
https://hvt-journal.com/articles/art73 |
work_keys_str_mv |
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