Studija slučaja
https://doi.org/https://doi.org/10.64542/pc1.19.5
Physiotherapy approach to a patient with extensive aortic dissection and paraplegia - a case report
Andrija Poljak
; KB Sveti Duh, Zagreb
Snježana Benko Meštrović
orcid.org/0000-0002-4092-9434
; KB Sveti Duh, Zagreb
*
Nikolina Marić
; KB Sveti Duh, Zagreb
* Dopisni autor.
Sažetak
Introduction: Aortic dissection (AD) is a rare, life threatening condition that usually presents with intense chest pain. The only life-saving treatment is surgical intervention, which should be performed as soon as possible to avoid a fatal outcome. Postoperatively, AD can be accompanied by numerous complications, one of the rarest being paraplegia. This paper aims to present a physiotherapeutic approach to a patient with extensive AD complicated by paraplegia. Case report: A 64-year-old male patient, recently discharged from Cardiac Surgery where he underwent surgical treatment of an AD type A, which was complicated by paraplegia caused by malperfusion syndrome, and a large stage 4 presacral pressure ulcer, was admitted
to the Medical Intensive Care Unit (MICU) with signs of septic shock and multiorgan dysfunction caused by nosocomial bacterial pneumonia. At the beginning of hospitalization the patient was mechanically ventilated and analgosedated, presenting with respiratory and peripheral muscle weakness and hypersecretion. Following the implementation of intensive care measures, including physiotherapy initiated from day one, the patient was successfully weaned from mechanical ventilation after
23 days and continued to breathe spontaneously via an endotracheal cannula, which was removed after one month.
At that point, he was able to speak, cough, and swallow. Due to significant respiratory muscle weakness, respiratory
physiotherapy was administered daily to promote airway clearance and maintain pulmonary function. After two
months of intensive physiotherapy, muscle contractions became evident in the upper limbs and upper trunk, and
the patient achieved independent sitting. Following a 108 day stay in our MICU, the patient was discharged home
with a prescription for physical therapy, home nursing care, a wheelchair, and an anti-decubitus mattress.
Conclusion: To our knowledge, this is the first case report describing a physiotherapy approach in a patient
with Stanford type A AD complicated by paraplegia. This case also highlights the importance of a dedicated,
multidisciplinary therapeutic approach in the recovery of chronically critically ill patients.
Ključne riječi
aortic dissection, Stanford type A, paraplegia, physiotherapy, rehabilitation
Hrčak ID:
346243
URI
Datum izdavanja:
3.10.2025.
Posjeta: 119 *