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Respiratory physiotherapy in patients with Cystic Fibrosis and upper limb deep vein thrombosis
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  • Tomer Israeli,
  • Iris Eisenstadt,
  • David Shoseyov,
  • Shoshana Armoni,
  • Alex Gileles-Hillel,
  • Galit Cremisi,
  • Malena Cohen-Cymberknoh,
  • Oded Breuer
Tomer Israeli
Hadassah Medical Center

Corresponding Author:[email protected]

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Iris Eisenstadt
Hadassah Medical Center
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David Shoseyov
Hadassah Medical Center
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Shoshana Armoni
Hadassah Medical Center
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Alex Gileles-Hillel
Hadassah Medical Center
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Galit Cremisi
Hadassah Medical Center
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Malena Cohen-Cymberknoh
Hadassah Medical Center
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Oded Breuer
Hadassah Medical Center
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Abstract

We report physiotherapy management of two patients with severe cystic fibrosis (CF) lung disease and upper limb deep vein thrombosis (DVT). These patients were admitted due to a pulmonary exacerbation. Following peripherally inserted central catheters they were diagnosed with an upper limb DVT. Due to their underlying lung disease, physiotherapy was mandatory for improvement. However, the DVT and anticoagulation treatment raised concerns for pulmonary emboli and hemoptysis. A framework for physiotherapy management in these patients, using a set of precautions and restrictions to maintain airway clearance while minimizing risk for pulmonary emboli and hemoptysis, was established. Using these set of instructions, the patients experienced no major adverse event while maintaining sufficient airway clearance to allow respiratory improvement. These precautions were continued until the upper limb DVTs resolved. To our knowledge there are currently no guidelines nor expert opinions available. Therefore, this framework can help guide physiotherapy management.
23 Dec 2021Submitted to Pediatric Pulmonology
27 Dec 2021Submission Checks Completed
27 Dec 2021Assigned to Editor
28 Dec 2021Reviewer(s) Assigned
31 Jan 2022Review(s) Completed, Editorial Evaluation Pending
03 Feb 2022Editorial Decision: Revise Minor
27 Feb 20221st Revision Received
28 Feb 2022Submission Checks Completed
28 Feb 2022Assigned to Editor
28 Feb 2022Reviewer(s) Assigned
14 Mar 2022Review(s) Completed, Editorial Evaluation Pending
15 Mar 2022Editorial Decision: Revise Minor
17 Mar 20222nd Revision Received
18 Mar 2022Submission Checks Completed
18 Mar 2022Assigned to Editor
18 Mar 2022Reviewer(s) Assigned
20 Mar 2022Review(s) Completed, Editorial Evaluation Pending
22 Mar 2022Editorial Decision: Accept
Jun 2022Published in Pediatric Pulmonology volume 57 issue 6 on pages 1552-1554. 10.1002/ppul.25903