A case of long-term comprehensive rehabilitation culminated in weaning from a ventilator and regaining oral intake for a patient who underwent tracheostomy, mechanical ventilation, and alternative nutritional management because of type II respiratory failure after ascending aortic artificial vascular replacement.

Abstract

Mizumoto T, Matsubara K, Kambayashi Y, Nomura T, Fukushima A, Ueki Y, Aida N. A case of long-term comprehensive rehabilitation culminated in weaning from a ventilator and regaining oral intake for a patient who underwent tracheostomy, mechanical ventilation, and alternative nutritional management because of type II respiratory failure after ascending aortic artificial vascular replacement. Jpn J Compr Rehabil Sci 2026; 17: 8-15. Long-term mechanical ventilation and alternative nutritional management make it difficult to wean patients from the ventilator and to regain oral intake. Furthermore, persistent functional dysfunction also makes it difficult to maintain motivation for rehabilitation training and markedly reduces quality of life (QOL). In this report, we describe a case in which comprehensive rehabilitation achieved favorable results in a patient who underwent long-term mechanical ventilation and alternative nutritional management. The patient was a woman in her eighties. In February of year X, she developed type II respiratory failure due to phrenic nerve injury after artificial vascular replacement of the ascending aorta. She subsequently underwent tracheostomy, mechanical ventilation, and alternative nutritional management for six months. She was transferred to our hospital in August of year X. At the time of intervention, respiratory and swallowing dysfunction and general muscle weakness were observed. She wished to attend her grandchild's wedding scheduled for the following year and began training with the long-term goal of attending the wedding. Multidisciplinary rehabilitation programs incorporating swallowing, respiratory and phonation training, and whole-body exercise were carried out in stages in collaboration with multiple professionals. After approximately one year of training, she achieved weaning from both mechanical ventilation and alternative nutritional management, regained independent ambulation and oral intake of three meals per day, and successfully attended the wedding. This case demonstrates that even in patients with long-term respiratory and swallowing dysfunction, clear goal setting and stepwise comprehensive rehabilitation can lead to meaningful functional recovery and improvements in QOL.