Rehabilitation in a Patient with Restrictive Lung Disease Due to Post Partial Right Inferior Lobe Resection with Phrenic Nerve Palsy: Case Report

Abstract

The process of surgical resection is a complex procedure that raises several concerns after experiencing thoracic trauma. Injuries or cardiothoracic surgical interventions have the potential to give rise to phrenic nerve dysfunction, leading to diaphragmatic weakening, a reduction in inspiratory muscle capacity, and decreased lung volume. This impairs respiratory muscle endurance, ultimately manifesting as exertional dyspnea. A 19-year-old male patient with weaning ventilator failure following inferior lobe resection of the right lung and phrenic nerve palsy is the subject of the following case. After achieving stable hemodynamics in the patient, the pulmonary rehabilitation program within the intensive care unit was initiated. Therefore, this program was conducted to improve ventilation, lung volume, and capacity, as well as diaphragmatic excursion. Exercise capacity improved from a six-minute walking test, which covered 135 meters with a VO2 max of 10.04 and 2.87 metabolic equivalent (METs) before discharge. In the outpatient clinic setting, these values improved with the patient able to cover a distance of 294 meters, exhibiting a VO2 max of 13.17, and a METs value of 3.76.