This document provides information on lung transplantation and the role of physiotherapy. It discusses the types of lung transplants including single lung, double lung, lobar, and heart-lung transplants. The causes for transplantation and post-operative care are described. Pre-operative physiotherapy aims to prepare the patient while post-operative physiotherapy focuses on clearing secretions, expanding the lungs, and regaining mobility and fitness over several weeks of treatment and rehabilitation. Modalities like incentive spirometry, postural drainage, and positive pressure breathing may be used as needed.
CHEST MOBILIZATION EXERCISES, COUNTER-ROTATION TECHNIQUE, BUTTERFLY TECHNIQUE, BREATH CONTROL DURING WALKING. These Mobilization Techniques are useful to improve Chest Wall Mobility and Expansion in Patients with Restricted Chest wall movements and also Postoperative patients
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
CHEST MOBILIZATION EXERCISES, COUNTER-ROTATION TECHNIQUE, BUTTERFLY TECHNIQUE, BREATH CONTROL DURING WALKING. These Mobilization Techniques are useful to improve Chest Wall Mobility and Expansion in Patients with Restricted Chest wall movements and also Postoperative patients
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
physiotherapy management for chronic obstructive pulmonary disease Sunil kumar
role of physiotherapy in chronic obstructive pulmonary disease, principles of physical therapy management in copd, physiotherapy assessing and treatment for copd
physiotherapy management for chronic obstructive pulmonary disease Sunil kumar
role of physiotherapy in chronic obstructive pulmonary disease, principles of physical therapy management in copd, physiotherapy assessing and treatment for copd
Breathing exercise are indicated in any pathological state, which cauuse the patient to use his muscles of respiration insufficiently resulting in an impotent of pulmonary function. Generally any patient with an abdominal pattern of breathing or increased work of breathing. Breathing exercise are form of exercise that can be used for a variety of health related reasons. improper breathing can upset the oxygen and carbon dioxide exchange and contribute to anxiety, panic attacks, fatigue, and other physical and emotion disturbance. diaphragmatic breathing is a type of breathing
The process that moves air in and out of the lungs called breathing or pulmonary ventilation.
Breathing is only one of the processes that deliver oxygen to where it is needed in the body and remove carbon dioxide.
Breathing exercise enhance the respiratory system.
Improper breathing can upset the oxygen and carbon dioxide exchange.
4. Physiotherapeutic approach of management in mechanically ventilated patient.ShagufaAmber
Mechanical ventilation (MV) is one of the most common interventions in the intensive care unit (ICU). Physical therapy includes early mobilisation to improve functional outcomes. Physical therapy interventions include passive movements of the extremities for deeply sedated patients, in-bed and out-of-bed mobility, active or passive cycling ,neuromuscular electrical stimulation and ambulation.Chest physiotherapy facilitates removal of retained or profuse airway secretions aiming to reduce airway resistance, optimize lung compliance, and decrease the work of breathing. Multimodality respiratory physiotherapy appeared to reduce mortality in ICU patients.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
3. LUNG TRANSPLANTATION:
Lung transplantation or pulmonary transplantation is a surgical
procedure in which a patient's diseased lungs are partially or totally replaced
by lungs which come from a donor.
Donor lungs can be retrieved from a living donor or a deceased donor.
A living donor can only donate one lung lobe. With some lung diseases a
recipient may only need to receive a single lung. With other lung diseases
such as cystic fibrosis it is essential that a recipient receive two lungs.
While lung transplants carry certain associated risks, they can also extend
life expectancy and enhance the quality of life for end-stage
pulmonary patients.
4. CAUSES OR REASONS FOR
TRANSPLANTATIONThe most common reasons for lung transplantation:
Chronic obstructive pulmonary disease (COPD),
including emphysema;
Idiopathic pulmonary fibrosis;
Cystic fibrosis;
Idiopathic (formerly known as "primary") pulmonary
hypertension;
Replacing previously transplanted lungs that have
since failed;
other causes, including bronchiectasis
6. TYPES OF LUNG
TRANSPLANTATION:
Lobe
A lobe transplant is a surgery in which part of a living
or deceased donor's lung is removed and used to
replace the recipient's diseased lung. In living
donation, this procedure requires the donation of
lobes from two different people, replacing a lung on
each side of the recipient. Donors who have been
properly screened should be able to maintain a normal
quality of life despite the reduction in lung volume. In
deceased lobar transplantation, one donor can provide
both lobes.
7. TYPES OF LUNG
TRANSPLANTATION: CONTI:
Single-lung
Many patients can be helped by the transplantation of a single
healthy lung. The donated lung typically comes from a donor
who has been pronounced brain-dead.
Double-lung
Certain patients may require both lungs to be replaced. This is
especially the case for people with cystic fibrosis, due to the
bacterial colonization commonly found within such patients'
lungs; if only one lung were transplanted, bacteria in the native
lung could potentially infect the newly transplanted organ.
8. Heart–lung
Heart–lung transplant
Some respiratory patients may also have severe cardiac
disease which require a heart transplant. These patients
can be treated by a surgery in which both lungs and the
heart are replaced by organs from a donor or donors.
A particularly involved example of this has been termed a
"domino transplant" in the media. First performed in 1987
9. POST-OP CARE
Immediately following the surgery, the patient is placed in
an intensive care unit for monitoring, normally for a period of a few
days.
The patient is put on a ventilator to assist breathing.
Nutritional needs are generally met via nasogastric tube.
Chest tubes are put in so that excess fluids may be removed.
Because the patient is confined to bed, a urinary catheter is used.
IV lines are used in the neck and arm for monitoring and giving
medications. Special care is taken to look for rejection of organ or
infection
10.
11.
12. POST-OP CARE: CONTI:
After a few days, without any complications, the
patient may be transferred to a general inpatient ward
for further recovery. The average hospital stay
following a lung transplant is generally one to three
weeks, though complications may require a longer
period of time.
After this stage, patients are typically required to
attend rehabilitation gym for approximately 3 months
to regain fitness. Light weights, exercise bike,
treadmill, stretches and more are all a part of the
rehabilitation programme.
14. Preoperative Physiotherapy
This should begin as soon as possible after the patient is
admitted. The main aims are to:
1- Gain the patient confidence
2- Clear the lungs fields
3- Teach respiratory control and inspiratory holdings
4- Teach postural awareness
5- Teach arm, trunk and leg exercises
6- Teach mobility about the bed.
Patient’s confidence
An explanation of the aim of physiotherapy helps the patient’s
understanding. Teaching the exercises to be undertaked
postoperatively and answering the patient’s questions helps to
relieve some of the fears of operations.
15. Clearing lung Fields
The patient must be discouraged from smoking.
Shaking, clapping and vibrations with postural drainage if necessary must be
used to clear the secretions from the sound lung.
Huffing is taught as this is used in preference to coughing postoperatively.
The patient is instructed on how to support the wound during coughing and
huffing. The arm of unaffected side is placed across the front of the thorax
and around the affected side just below the incision side giving firm pressure
with the forearm and hand.
Teaching the respiratory control
Inspiratory exercises are taught for the sound lung together with the
inspiratory holding. This means that the patient is asked to take a deep breath
in, hold, then breathe in a little further, hold, then breathe out.
Breathing control has to be practiced after secretions have been cleared.
16. Postoperative physiotherapy
It is important to note whether the patient is on oxygen therapy, and whether there is drain in
the thorax. This drain may be used to control the amount of fluid in the cavity left by the lung. If
there is too much fluid, or too less the mediastinum is shifted In both instances there will be loss
of breath and a danger of heart being compromised.
Rate and depth of respiration are recorded. The aims of physiotherapy are:
1- Clear secretions from the remaining lung
2- Retain full expansion of the lung tissue
3- Prevent circulatory complications
4- Prevent wound complications
5- Regain arm and spinal movements
6- Maintain good posture
7- Restore exercise tolerance
A suitable programme may be as follows.
17. After operation:
If the patient is stable and is not on ventilator usually initially patient is on ventilator
Expansion breathing exercises for all areas of the lung. Foot and ankle
exercises
More often the treatment involves
The techniques of breathing control
Well supported positioning,
Utilization of the stimulation and reassurance of hands on instruction alternated
with shoulder and soft tissue techniques can bring about the change in the
respiratory pattern and rate, and positively affect the arterial blood gases and
haemodynamic status.
Initial treatment involves Airway clearance and few breathing exercises with
postural drainage
18. Day-1 Post-operation
Half lying-Segmental expansion exercises, shaking or vibrations as necessary
Huffing and expectoration with wound support from the physiotherapist.
By the end of the day the patient should be huffing with self support.
Foot and ankle exercises.
Correct posture should be emphasized to prevent a scoliosis on the scar side.
Short frequent sessions are better than few long ones. In the afternoon, the patient may sit
out of the bed. This allows better excursion of the diaphragm.
During two of the sessions the arm on the affected side must be moved.
1- Into full elevation
2- Hand behind head
3- Hand behind back
4- Hand touch opposite shoulder
19. Day 2 Post-operation
Treatment is continued as above plus on two sessions:
1- Sitting on the edge of the bed
(a) Trunk turning
(b) Trunk bending side to side
(c) Trunk stretching backwards
2- Sitting in chair-Bilateral breathing exercises
3- Walk round bed with trunk erect and arms swinging
Day 3 Post operation
Breathing and huffing is continued as necessary. Other activities continue twice in a day. The
patient may join in group therapy.
Day 4 post operation to discharge
The patient continues with group therapy, gets dressed, and walks further and, after the 7th day,
practices going up and down stairs with breathing control. Bilateral breathing and trunk and arm
exercises are essential.
Stitches come out usually 7-10 days after operation. Two weeks after the operation, the patient is
generally discharged with strict instructions to continue the exercise regimen.
20. GENERAL REGIMEN:
lower extremity
• In bed
• Knee to chest
• Hip abduction/adduction (supine)
• Ankle pumps
• Straight leg raise
• Hip abduction in side lying etc.
• In the chair
• Hip flexion
• Knee extension
• Sit to stand etc.
• In standing
• Standing calf lift
• Mini-squat (wall squat)
Upper extremity
• In bed (on the mat)
• Biceps curl
• Triceps curl
• Bench press
• Anterior arm lift
• Strength/Postural Exercises
• Neck and trunk
• Shoulder circles;
• Cervical range of motion;
• Trunk lateral flexion
21. Modifications to this programme
Postural drainage may be necessary if the remaining lung does not clear
satisfactorily. This involves positioning the patient on the operation side.
If the air entry to the remaining lung is not adequate, intermittent positive
pressure breathing may be used to improve ventilation.
Oxygen therapy and humidification may be necessary.
If the recurrent laryngeal nerve is injured, breathing exercises and huffing should
clear the secretions. IPPB used with caution at low pressure and only after
consultation with surgeon.
If phrenic nerve is damaged, coughing can be ineffective because there is
paradoxical movement of the diaphragm. IPPB can be used to mobilize secretions
and increase air entry.
Incentive spirometry may be helpful to improve the patient’s inspiratory capacity.
22. Incentive Spirometry
This a technique used to encourage the patient to take a deep
breath in when there is hypoventilation after thoracic or high
abdominal surgery due to pain or secretions retention. The
breathes in through a tube which is attached to a device that
demonstrate the volume of the inspired air. For example, at low
lung volume, a plastic ball rises to the top of the column, at
mid lung volume a second ball rises and at high lung volume a
third ball rises. So long as the patient holds a deep breath, the
balls remain at the top of the columns. Some devices operate
by a light coming on when the volume of breath reaches a pre
set level. Some devices work on the expiratory phase rather
than the inspiratory phase.
23.
24. Long term management
Rehabilitation training to improve
patient physical condition ( posture, strength, endurance),
performing the full range of activities of daily living
appropriate exercise activities,
promoting independence in maintaining and monitoring the
physical condition.
In patient attend the gymnasium 1-2 times daily.
Out patients are encouraged to attend the gymnasium 3-5
times weekly.
Activities are introduced at intensity such that patient’s
subjective description of his level of exertion is very light or
light.
The intensity is subsequently progressed to the level of
25. Post surgery long term rehab:
Treadmill Warm up 12 minutes
Bicycle ergometer Endurance/aerobic fitness 5-40minutes
Quadriceps strengthening 12-30 repetitions
Rowing machine Quadriceps/upper limb/upper trunk
strengthening 12-30 repetitions
Weights Upper limbs and shoulder girdle strengthening 1-10 KG,
10-30 repetitions
lower limb strengthening 1-15 minutes
Wobble Boards Ankle/Knee stability 1-5 minutes