호흡기 중환자실에 입원한 만성폐쇄성폐질환을 가진 고령 폐암 절제술 환자의 중환자 재활치료 효과: 단일 사례 연구

Effects of ICU-Based Rehabilitation on an Elderly Patient with COPD after Lung Cancer Resection: A Case Report from a Respiratory Intensive Care Unit

Purpose: The present single-case study investigated the effects of intensive care unit (ICU) rehabilitation in an elderly patient with chronic obstructive pulmonary disease following video-assisted thoracoscopic surgery (VATS) wedge resection for lung cancer. Methods: An 81-year-old man with right upper lobe non-small cell lung cancer underwent video-assisted thoracoscopic surgery (VATS) wedge resection. ICU rehabilitation, including active range of motion exercise, resistance exercise, breathing exercise, and functional movement training, was delivered by a respiratory nurse and physical therapist team over 38 days. The functional and muscle-related outcomes were assessed at baseline, day 13, and day 31. Results: The patient’s Medical Research Council Sum Score improved from 35 to 52 by day 13 and then declined to 45 by day 31. His Functional Status Score for the ICU increased from 0 to 18 and then dropped to 7. His hand grip strength also improved from 15.67 (right) and 9.33 ㎏ (left) to 18.00 and 11.33 ㎏ and then decreased to 17.33 and 8.67 ㎏, respectively. Surface electromyography of the vastus medialis and vastus lateralis increased from 32.02 and 50.11 ㎶ to 54.80 and 64.21 ㎶ and then decreased to 45.05 and 58.40 ㎶, respectively. Conclusion: Short-term improvements in strength and mobility were observed following ICU rehabilitation. However, clinical deterioration and prolonged mechanical ventilation limited recovery. These findings support the potential benefits of ICU rehabilitation and underscore the need for further research with larger cohorts.