Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun 27;9(1):9347.
doi: 10.1038/s41598-019-45828-2.

Pulmonary rehabilitation improves survival in patients with idiopathic pulmonary fibrosis undergoing lung transplantation

Juliessa Florian  1   2   3 , Guilherme Watte  4   5 , Paulo José Zimermann Teixeira  3   6 , Stephan Altmayer  7 , Sadi Marcelo Schio  2 , Letícia Beatriz Sanchez  2 , Douglas Zaione Nascimento  2 , Spencer Marcantonio Camargo  2 , Fabiola Adélia Perin  2 , José de Jesus Camargo  2 , José Carlos Felicetti  2 , José da Silva Moreira  1
Affiliations

Pulmonary rehabilitation improves survival in patients with idiopathic pulmonary fibrosis undergoing lung transplantation

Juliessa Florian et al. Sci Rep. .

Abstract

This study was conducted to evaluate whether a pulmonary rehabilitation program (PRP) is independently associated with survival in patients with idiopathic pulmonary fibrosis (IPF) undergoing lung transplant (LTx). This quasi-experimental study included 89 patients who underwent LTx due to IPF. Thirty-two completed all 36 sessions in a PRP while on the waiting list for LTx (PRP group), and 53 completed fewer than 36 sessions (controls). Survival after LTx was the main outcome; invasive mechanical ventilation (IMV), length of stay (LOS) in intensive care unit (ICU) and in hospital were secondary outcomes. Kaplan-Meier curves and Cox regression models were used in survival analyses. Cox regression models showed that the PRP group had a reduced 54.0% (hazard ratio = 0.464, 95% confidence interval 0.222-0.970, p = 0.041) risk of death. A lower number of patients in the PRP group required IMV for more than 24 hours after LTx (9.0% vs. 41.6% p = 0.001). This group also spent a mean of 5 days less in the ICU (p = 0.004) and 5 days less in hospital (p = 0.046). In conclusion, PRP PRP completion halved the risk of cumulative mortality in patients with IPF undergoing unilateral LTx.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of the study. LTx: lung transplantation; ECMO: extracorporeal membrane oxygenation; IPF: idiopathic pulmonary fibrosis; PRP: pulmonary rehabilitation program.
Figure 2
Figure 2
Kaplan-Meier curves of cumulative survival of patients stratified by PRP status after lung transplantation. PRP = pulmonary rehabilitation program.
See this image and copyright information in PMC

References

    1. Raghu Ganesh. Idiopathic pulmonary fibrosis: lessons from clinical trials over the past 25 years. European Respiratory Journal. 2017;50(4):1701209. doi: 10.1183/13993003.01209-2017. - DOI - PubMed
    1. Raghu G, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am. J. Respir. Crit. Care Med. 2011;183:788–824. doi: 10.1164/rccm.2009-040GL. - DOI - PMC - PubMed
    1. Caminati Antonella, Cassandro Roberto, Torre Olga, Harari Sergio. Severe idiopathic pulmonary fibrosis: what can be done? European Respiratory Review. 2017;26(145):170047. doi: 10.1183/16000617.0047-2017. - DOI - PMC - PubMed
    1. Dowman, L., Hill, C. J. & Holland, A. E. Pulmonary rehabilitation for interstitial lung disease. Cochrane Database of Systematic Reviews (2014). - PubMed
    1. Dowman LM, et al. The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial. Thorax. 2017;72:610–619. doi: 10.1136/thoraxjnl-2016-208638. - DOI - PubMed