Lung Transplant Ex Rx
Maddie
Created on November 11, 2024
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Transcript
Maddie Davis
Lung Transplant
exercise prescription and special considerations
Lobar
Heart - Lung
A lung transplant is a procedure to replace a diseased or failing lung with a healthy donor lung
Double
Single
Risk Factors Leading to transplantRisk Factors post transplant
COPD
Cystic Fibrosis and idiopathic pulmonary fibrosis
Pulmonary hypertension
Smoking
Recurrent infections
Rejection of transplant
Infection
blockage of blood vessels and airways to new lungs
pulmonary edema
bleeding
Blood clots
Death
ABSTINENCE FROM SMOKING AND SUBSTANCE ABUSE FOR AT LEAST 6 MONTHS
Criteria for Lung Transplantation
HAVE ADVANCED LUNG DISEASE (HIGH RISK OF DEATH WITHIN 2 YEARS)
LIKELIHOOD OF SURVIVING AT LEAST 90 DAYS POST TRANSPLANT
LIKELIHOOD OF SURVIVING 5 YEARS POST TRANSPLANT
HAVE NO OTHER LIFE THREATENING DISEASES
DEPENDENT ON SUPPLEMENTAL OXYGEN
GENERALLY 70 YEARS OLD OR YOUNGER
SOCIAL, PSYCHIATRIC OR FINANCIAL PROBLEMS
ABSOLUTE CONTRAINDICATIONS
RELATIVE CONTRAINDICATIONS
OLDER THAN 75 YEARS OLD OR OLDER THAN 65 YEARS OLD WITH LOW EXERCISE CAPACITY
SEVERE MALNUTRITION/CACHEXIA OR OBESITY
CHRONIC PREDNISONE USE
SEVERE OR SYMPTOMATIC OSTEOPOROSIS
PRIOR SIGNIFICANT THORACIC SURGERY
COLONIZATION WITH RESISTANT ORGANISMS
INABILITY TO ADHERE TO MEDICAL THERAPY
CANCER DIAGNOSIS WITHIN LAST 5 YEARS
ACTIVE SMOKER AND/OR SUBSTANCE ABUSE
ACUTE UNSTABLE MEDICAL PROBLEMS
MORBID OBESITY
END STAGE RENAL OR LIVER DISEASE
SEVERE LOCAL OR SYSTEMIC INFECTION
daily life and health outlook
The role of exercise is to improve QOL, increase skeletal muscle and BMD.
Self maintenance strategies
Exercise training and support
pulmonary rehab
Energy conservation
Nutritional advice
Action plan
Breathing techniques and management
Baseline outcomes and management
Management of comorbidities
Other comorbidities
Considerations for Exercise Testing and program design
Impaired oxidative capacity
Sternal Precautions
Lower portion of Type 1 fibers
Active use of immunosuppressants
Skeletal muscle changes
Week 1
Frequency: 2 days/week, nonconsecutiveIntensity: 60% 1 RMTime: 2-4 sets, 8-12 reps
Frequency: 3 days/wkIntensity: 50% peak work rate, 4-6 on Borg CR10Time: 20-30min
Week 4
Frequency: 2 days/week, nonconsecutiveIntensity: 65% 1 RMTime: 2-4 sets, 8-12 reps
Frequency: 4 days/wkIntensity: 65% peak work rate, 4-6 on Borg CR10Time: 30-45min
Week 8
Frequency: 2-3 days/week, nonconsecutiveIntensity: 70% 1 RMTime: 2-4 sets, 8-12 reps
Frequency: 5 days/wkIntensity: 80% peak work rate, 4-6 on Borg CR10Time: 45-60min
- Intensity can be monitored by RPE scale
- SpO2 should be monitored during exercise
- Encouraged to work at the highest intensity they are able to tolerate
- Adherence to an exercise program can improve their QOL, increase oxidative capacity and manage other comorbidities
CONCLUSIONS
American Thoracic Society. Lung transplantation. Thoracic.org.Retrieved from https://www.thoracic.org/professionals/career-development/residents-medical-students/ats-reading-list/adult/lung-transplantation.phpMadeline Paternostro Bayles. ASCM's exercise testing and prescription. Wolters Kluwer.
References