Importance of proper ventilator support and pulmonary rehabilitation in obese patients with heart failure:Two case reports  

作　　者：Eun-Hee Lim Sung-Hee Park Yu Hui Won 

机构地区：[1]Physical Medicine and Rehabilitation,Jeonbuk National University Medical School,Jeonju 54907,South Korea [2]Department of Physical Medicine and Rehabilitation,Jeonbuk National University Medical School,Jeonju 54907,South Korea [3]Research Institute of Clinical Medicine of Jeonbuk National University,Biomedical Research Institute of Jeonbuk National University Hospital,Jeonju 54907,South Korea

出　　处：《World Journal of Clinical Cases》2023年第13期3029-3037,共9页世界临床病例杂志

基　　金：Supported by The“Research Base Construction Fund Support Program”funded by Jeonbuk National University in 2021.

摘　　要：BACKGROUND The optimal treatment for heart failure(HF)is a combination of appropriate medications.Controlling the disease using only medical therapy is difficult in patients with HF,severe hypercapnia,and desaturation.These patients should first receive ventilator support followed by pulmonary rehabilitation(PR).CASE SUMMARY We report two cases in which arterial blood gas(ABG)improved and PR was possible with appropriate ventilator support.Two patients with extreme obesity complaining of worsening dyspnea–a 47-year-old woman and a 36-year-old man both diagnosed with HF–were hospitalized because of severe hypercapnia and hypoxia.Despite proper medical treatment,hypercapnia and desaturation resolved in neither case,and both patients were transferred to the rehabilitation department for PR.At the time of the first consultation,the patients were bedridden because of dyspnea.Oxygen demand was successfully reduced once noninvasive ventilation was initiated.As the patients’dyspnea gradually improved to the point where they could be weaned off the ventilator during the daytime,they started engaging in functional training and aerobic exercise.After 4 mo of followup,both patients were able to perform activities of daily living and maintain their lower body weight and normalized ABG levels.CONCLUSION Symptoms of patients with obesity and HF may improve once ABG levels are normalized through ventilator support and implementation of PR.

关 键 词：Noninvasive ventilation Heart failure OBESITY REHABILITATION DYSPNEA Case report 

分 类 号：R541.6[医药卫生—心血管疾病]