https://doi.org/10.4081/monaldi.2024.2898
Respiratory and physical therapy in the intensive care unit after liver transplantation for acute-on-chronic liver failure: a case report
Submitted: January 2, 2024
Accepted: July 20, 2024
Published: September 10, 2024
Accepted: July 20, 2024
Abstract Views: 654
PDF_EARLY VIEW: 192
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Acute-on-chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation (LT) is the only curative option. Due to the recipients' generally poor pre-operative clinical conditions and extensive surgery, post-LT respiratory disorders are very common and significantly contribute to related morbidity and mortality. We report the case of a 49-year-old patient with ACLF grade 3 who has been taken care of by the Respiratory Physiotherapy Team since hospital admission. After the extubation, the patient was supported with non-invasive ventilation and mechanical in-exsufflation; meanwhile, early resistance and functional training were started. No adverse events occurred during physiotherapy sessions, and the patient returned home without respiratory support. Respiratory and physical therapy in the intensive care unit after LT were safe and feasible interventions for this patient. Given the high incidence of postoperative pulmonary complications and the high rehabilitation needs, we suggest that physiotherapy should be provided for ACLF recipients.
Perricone G, Artzner T, De Martin E, et al. Intensive care management of acute-on-chronic liver failure. Int Care Med 2023;49:903-21.
DOI: https://doi.org/10.1007/s00134-023-07149-x
Mezzano G, Juanola A, Cardenas A, et al. Global burden of disease: acute-on-chronic liver failure, a systematic review and meta-analysis. Gut 2022;71:148-55.
DOI: https://doi.org/10.1136/gutjnl-2020-322161
Belli LS, Duvoux C, Artzner T, et al. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS). J Hepatol 2021;75:610-22.
DOI: https://doi.org/10.1016/j.jhep.2021.03.030
Feltracco P, Carollo C, Barbieri S, et al. Early respiratory complications after liver transplantation. World J Gastroenterol 2013;19:9271-81.
DOI: https://doi.org/10.3748/wjg.v19.i48.9271
Laici C, Guizzardi C, Morelli MC, et al. Predictive factors of inhospital mortality for ICU patients with acute-on-chronic liver failure undergoing liver transplantation. Eur J Gastroenterol Hepatol 2022;34:967-74.
DOI: https://doi.org/10.1097/MEG.0000000000002413
Chen GH, Wu RL, Huang F, et al. Liver transplantation in acute-on-chronic liver failure: excellent outcome and difficult posttransplant course. Front Surg 2022;9:914611.
DOI: https://doi.org/10.3389/fsurg.2022.914611
Sundaram V, Lindenmeyer CC, Shetty K, et al. Patients with acute-on-chronic liver failure have greater healthcare resource utilization after liver transplantation. Clin Gastroenterol Hepatol 2023;21:704-12.e3.
DOI: https://doi.org/10.1016/j.cgh.2022.03.014
Riley DS, Barber MS, Kienle GS, et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol 2017;89:218-35.
DOI: https://doi.org/10.1016/j.jclinepi.2017.04.026
Volpe MS, Guimarães FS, Morais CC. Airway clearance techniques for mechanically ventilated patients: insights for optimization. Respir Care 2020;65:1174-88.
DOI: https://doi.org/10.4187/respcare.07904
Hickmann CE, Montecinos-Munoz NR, Castanares-Zapatero D, et al. acute effects of sitting out of bed and exercise on lung aeration and oxygenation in critically ill subjects. Respir Care 2021;66:253-62.
DOI: https://doi.org/10.4187/respcare.07487
Zhang L, Hu W, Cai Z, et al. Early mobilization of critically ill patients in the intensive care unit: A systematic review and meta-analysis. PLoS One 2019;14:e0223185.
DOI: https://doi.org/10.1371/journal.pone.0223185
Brustia R, Monsel A, Skurzak S, et al. Guidelines for perioperative care for liver transplantation: enhanced recovery after surgery (eras) recommendations. Transplantation 2022;106:552-61.
DOI: https://doi.org/10.1097/TP.0000000000003808
Cork G, Camporota L, Osman L, Shannon H. Physiotherapist prediction of extubation outcome in the adult intensive care unit. Physiother Res Int 2019;24:e1793.
DOI: https://doi.org/10.1002/pri.1793
Thille AW, Boissier F, Muller M, et al. Role of ICU-acquired weakness on extubation outcome among patients at high risk of reintubation. Crit Care 2020;24:86.
DOI: https://doi.org/10.1186/s13054-020-2807-9
Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J 2017;50:1602426.
DOI: https://doi.org/10.1183/13993003.02426-2016
Oczkowski S, Ergan B, Bos L, et al. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. Eur Respir J 2022;59:2101574.
DOI: https://doi.org/10.1183/13993003.01574-2021
Bach JR, Gonçalves MR, Hamdani I, Winck JC. Extubation of patients with neuromuscular weakness: a new management paradigm. Chest 2010;137:1033-9.
DOI: https://doi.org/10.1378/chest.09-2144
Chatwin M, Toussaint M, Gonçalves MR, et al. Airway clearance techniques in neuromuscular disorders: a state of the art review. Respir Med 2018;136:98-110.
DOI: https://doi.org/10.1016/j.rmed.2018.01.012
Christensen M, Trapl M. Development of a modified swallowing screening tool to manage post-extubation dysphagia. Nurs Crit Care 2018;23:102-7.
DOI: https://doi.org/10.1111/nicc.12333
How to Cite
Tarello, Davide, Francesca Giogà, Andrea Lauterio, Chiara Becchetti, Giovanni Perricone, Giorgio Santi, Monica Ragazzi, Gianpaola Monti, and Marta Lazzeri. 2024. “Respiratory and Physical Therapy in the Intensive Care Unit After Liver Transplantation for Acute-on-Chronic Liver Failure: A Case Report”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2024.2898.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Mehmet Erdem Çakmak, Saltuk Buğra Kaya, Özge Can Bostan, Ebru Damadoğlu, Gül Karakaya, Ali Fuat Kalyoncu, Short- and long-term oral steroid therapy in patients with asthma exacerbation , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Jaikrit Bhutani, Aditya Batra, Mridul Doomra, Kunal Mahajan, Hemiazygous continuation of inferior vena cava draining into the coronary sinus via persistent left superior vena cava: a rare anomaly , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Amit Gupta, Aman Snehil, Sujeet Kumar, Roshan Chanchlani, Reyaz Ahmad, Keerti Swarnkar, Garima Goel, Bronchiectasis without lower respiratory symptoms in the presence of multisystem anomalies – a clinical clue to diagnose esophageal lung anomaly , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Kiran B, Rupak Singla, Neeta Singla, Vinay V, Kuljeet Singh, Madhumita Paul Choudhury, Nilotpal Bhattacherjee, Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India , Monaldi Archives for Chest Disease: Vol. 93 No. 3 (2023)
- Ashish Pundhir, Abhishek Jaiswal, Poonam Kushwaha, Akhil Dhanesh Goel, Anju Gahlot, Lakshmi Singh, Manmeet Kaur, A cross-sectional study on COVID-19 vaccine hesitancy in peri-urban areas in Kanpur, Uttar Pradesh, India , Monaldi Archives for Chest Disease: Vol. 94 No. 1 (2024)
- Yusuf Kayar, Nüket Bayram Kayar, Tuncay Şahutoğlu, Venkatanarayana Gangarapu, Spontaneous pneumomediastinum following pneumonia in a 23-year-old male patient , Monaldi Archives for Chest Disease: Vol. 83 No. 1-2 (2016): Pulmonary series
- Raj Kumar, Manoj Kumar, Sukriti Raj, Dileep Kumar Arisham, Anil Kumar Mavi, Kamal Singh, Smoking cessation and its significant role in the Indian scenario , Monaldi Archives for Chest Disease: Early Access
- Mohamed Elnady, Ahmed Abdel Hafeez, Hebatallah Assal, Eman Zaid, Gihan Abo Elwafa, Serum vitamin D levels and the severity and clinical course of COVID-19 , Monaldi Archives for Chest Disease: Early Access
- Ajay Kumar Mishra, Kamal Kant Sahu, Anu Anna George, Jennifer Sargent, Amos Lal, Cerebrovascular events in COVID-19 patients , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
You may also start an advanced similarity search for this article.
