Pulmonary rehabilitation for patients who undergo lung-volume-reduction surgery or lung transplantation.

Abstract

Patients preparing for or recovering from lung-volume-reduction surgery (LVRS) or lung transplantation represent a selected group of patients with advanced chronic respiratory disease. Such patients typically have severe ventilatory limitation and disability and are at high risk of preoperative and postoperative complications. Pulmonary rehabilitation is an ideal setting in which to: address the patient's questions and knowledge-deficits regarding his or her disease and its treatment; ensure that the patient understands the nature, potential benefits, risks, and expected outcomes of the surgery relative to medical therapies, and; prepare physically and emotionally for the surgery. Pulmonary rehabilitation also may improve survival to and/or outcomes of LVRS and transplantation, at least in part by stabilizing and improving the patient's exercise tolerance and muscle function. Further work is needed to determine whether pulmonary rehabilitation can augment the benefits and outcomes of LVRS or lung transplantation, reduce postoperative complications, or improve patient survival to or following the surgery.