Physical therapy management of two patients with stage d heart failure in the cardiac medical intensive care unit.

BACKGROUND AND PURPOSE Due to the increasing prevalence of heart failure (HF) and medical advances extending the life expectancy of patients with HF, physical therapists are often consulted to assist in the management of these patients in light of the benefits of exercise for them. The purpose of this paper is to review the equipment and measures often encountered in patients with Stage D HF in the intensive care unit (ICU) and to discuss the care provided to two patients in this setting. CASE DESCRIPTIONS One patient was a 40-year-old man with Stage D HF on multiple inotropes receiving physical therapy intervention while awaiting a cardiac transplant. The second patient was a 57-year-old man with Stage D HF due to ischemic cardiomyopathy, treated by physical therapy while receiving inotropic and intra-aortic balloon pump support, awaiting a renal and cardiac transplant. DISCUSSION Different physical therapy interventions were safely provided to both patients during their cardiac medical ICU courses. Despite multiple medical issues requiring more complex decision making skills, this patient population may greatly benefit from physical therapy intervention.