Early pulmonary rehabilitation after long term mechanical ventilation

Abstract

The term early rehabilitation is defined as a rehabilitation that begins in the early phase after acute illness and is statutory positioned in § 39SGB V. Aim of this investigation is to describe the quality of outcome of pulmonary early rehabilitation. Prospective census of functional parameters, status of ventilation and discharge-disposition in a specialized unit for early pulmonary rehabilitation over a period of one year. Out of 190 patients 179 (94.2 %) were previously invasively ventilated. During the treatment period of 39 ± 17days, FAM-Index increased from 84.4 ± 19.8 to 118.5 ± 23.3 (Ci 30.9 - 37.3, Cohen'd 1.58; p < 0.001), Barthel-Index from 30.5 ± 13.8 to 58.3 ± 16.2 (Ci 25.4 - 33.8, Cohen's d 1.4; p < 0.001) six minute walking distance from 12.9 ± 40.1 m to 131.4 ± 85.2 m (Ci 105.6 - 131.4 m, Cohn's d1.78; p < 0.001). Patients were less likely to be receive further post-discharge rehabilitation if they were ventilated. Patients admitted to the early pulmonary rehabilitation unit were severely compromised, however quality of outcome was favourable and independent of the breathing status (spontaneously breathing vs. non-invasive ventilation or invasive ventilation). Finding discharge dispositions appeared to be more difficult if patients were ventilated.