Article: Implementazione del modello ICD-ICF in medicina riabilitativa: presentazione di un caso clinico in riabilitazione respiratoria.
Giornale italiano di medicina del lavoro ed ergonomia
2019 Volume 41, Issue 2, Page(s) 150–155
Abstract: Summary: We present the clinical case of a 74 years old patient undergoing tracheotomy for persistent hypercapnic respiratory failure after lower right lobectomy surgery, performed as a result of pulmonary cancer recurrence. The patient was transferred ... ...
| Title translation | Implementation of the ICD-ICF model in rehabilitation medicine: report of a clinical case in respiratory rehabilitation. |
|---|---|
| Abstract | Summary: We present the clinical case of a 74 years old patient undergoing tracheotomy for persistent hypercapnic respiratory failure after lower right lobectomy surgery, performed as a result of pulmonary cancer recurrence. The patient was transferred to the Department of Respiratory Sub Intensive Care for respiratory weaning, decannulation and cycle of motor and respiratory physiotherapy. The joint evaluation of physicians, nurses and physiotherapists has allowed the identification of ICD-9 and ICF codes of the severe disability shown by the patient in the first days of hospital stay (respiratory failure due to pneumonia that need invasive mechanical ventilation by tracheotomy, prolonged immobility, muscular deconditioning and inability to perform even the simplest activities of daily life; it required also artificial nutrition by naso gastric tube). ICF codes as respiratory functions (respiratory system functions, additional respiratory functions, sensations associated with cardiovascular and respiratory functions, moving with aids, walking, vestibular functions, muscle strength, tolerance to physical exercise, personal care, performing the routine daily sleep functions, energy and drive functions), were particularly compromised at admission. Medical intervention (antibiotic therapy based on microbiological isolations, optimization of inhalatory therapy, management of intestinal complications and cardiological which required cardiological treatment remodulation in order to obtain better heart rate control and better blood pressure control allowed a clear improvement of general and respiratory clinical conditions. The simultaneous physiotherapists'intervention (weaning not only from invasive mechanical ventilation but also from tracheotomic cannula and oxygen therapy, stationary and cycloergometer with arms and exercise training) and nurses'intervention (medication of pressure injuries, surveillance of the sleep-wake rhythm, management of the daily routine) allowed a gradual improvement of both motor and respiratory ability with a consequent indipendence in activities of daily living. Important were also psychological counseling and intervention of speech therapists (removal of naso gastric tube, once excluded dysphagia also by videofluoroscopy). During a long lasting clinical improvement, coincident with patient's discharge to home, has been assessed disability through ICF codes, largely improved under medical, nursing and physiotherapist profile. |
| MeSH term(s) | Aged ; Humans ; Hypercapnia/etiology ; Hypercapnia/rehabilitation ; International Classification of Diseases ; International Classification of Functioning, Disability and Health ; Lung Neoplasms/surgery ; Male ; Physical Therapy Modalities ; Pneumonectomy/methods ; Respiration, Artificial/methods ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/rehabilitation ; Tracheotomy |
| Language | Italian |
| Publishing date | 2019-06-26 |
| Publishing country | Italy |
| Document type | Case Reports ; Journal Article |
| ZDB-ID | 603103-1 |
| ISSN | 1592-7830 ; 0391-9889 |
| ISSN | 1592-7830 ; 0391-9889 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Zs.B 2328: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.