Multidisciplinary respiratory rehabilitation after spontaneous pneumothorax in cystic lung disease - a case report with literature review

Sep 28, 2026

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Spontaneous pneumothorax is a recurrent, debilitating complication in cystic lung diseases and often requires invasive treatment, yet the role of multidisciplinary respiratory rehabilitation (MRR) after pneumothorax recovery remains unclear. A 51-year-old man with bullous cystic lung disease and persistent air leakage underwent video-assisted thoracoscopic surgery (VATS) and started an MRR protocol on postoperative day 2. Marked improvements occurred in pulmonary function and activities of daily living, supporting functional restoration.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

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Introduction

Case report

Postoperative Course and rehabilitation

Respiratory Medicine Case Reports 59 (2026) 102345 Contents lists available at ScienceDirect Respiratory Medicine Case Reports journal [homepage:](homepage: www.elsevier.com/locate/rmcr)[ www.elsevier.com/locate/rmcr](homepage: www.elsevier.com/locate/rmcr) Case Report Multidisciplinary respiratory rehabilitation after spontaneous pneumothorax in cystic lung disease: a case report with literature review Jia Shia , Rui Jiang b, Zixuan Yanga, Shan Yang c, Xiaobo Hub,* a Department of Rehabilitation Medicine, Chengdu Second People’s Hospital, Sichuan University, Chengdu, China b Department of Respiratory and Critical Care Medicine, Chengdu Second People’s Hospital, Sichuan University, Chengdu, China c Department of Integrative Traditional Chinese and Western Medicine, Chengdu Second People’s Hospital, Sichuan University, Chengdu, China A R T I C L E I N F O Keywords: Spontaneous pneumothorax Multidisciplinary respiratory rehabilitation (MRR) Cystic lung Disease video-assisted thoracoscopic surgery (VATS) Inspiratory muscle training (IMT) A B S T R A C T Background: Spontaneous pneumothorax (SP) is a recurrent and debilitating complication in cystic lung diseases (CLD), often requiring invasive interventions and multidisciplinary respiratory rehabilitation (MRR). However, evidence regarding the role of MRR in post-pneumothorax recovery remains limited. Case report: We report a 51-year-old male with bullous CLD and a 30-pack-year smoking history who presented with acute dyspnea and right-sided pneumothorax. Chest CT revealed extensive emphysematous bullae with 60–70 % lung collapse. After initial chest drainage failed to resolve persistent air leakage, the patient underwent video-assisted thoracoscopic surgery (VATS) for bullectomy and pleurodesis. A MRR protocol was initiated on postoperative day (POD) 2. Outcomes: Pulmonary function improved markedly, with FEV1 rising from 27.5 % predicted preoperatively to 55.4 % at the time of POD 48 (Discharge). Activities of daily living scores doubled from 40 to 80 points, reflecting substantial recovery of functional capacity. The patient ultimately returned to independent community living. Conclusion: This case highlights the critical role of MRR in optimizing outcomes after spontaneous pneumothorax in CLD patients. Integration of IMT, airway clearance, and early mobilization contributed to functional restoration despite significant postoperative complications. Furthermore, this finding underscores the value of personalized rehabilitation strategies in complex thoracic conditions. 1. Introduction Spontaneous pneumothorax (SP) is a recurrent and debilitating complication of cystic lung diseases (CLD), including lymphangioleiomyomatosis and Birt-Hogg-Dub´e syndrome, often requiring invasive procedures such as chest tube drainage or pleurodesis [1,2].Although conventional management achieves lung re-expansion and symptom relief, many patients continue to experience reduced exercise capacity, chronic dyspnea, and respiratory muscle weakness [3,4].Conventional rehabilitation often emphasizes physiological recovery but overlooks broader functional outcomes [5].Structured respiratory rehabilitation, incorporating inspiratory muscle training (IMT), aerobic conditioning, and psychological support, has recently been shown to enhance recovery [6]. IMT * Corresponding author. E-mail address: [1372090057@qq.com](1372090057@qq.com) (X. Hu). [https://doi.org/10.1016/j.rmcr.2025.102345](https://doi.org/10.1016/j.rmcr.2025.102345) Received 2 September 2025; Received in revised form 9 October 2025; Accepted 2 December 2025 Available online 3 December 2025 2213-0071/© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)). devices, such as PowerBreath®, significantly improve maximal inspiratory pressure

FAQs

What clinical problem does the case address?

The case addresses spontaneous pneumothorax in cystic lung disease, focusing on recovery after persistent air leakage and subsequent surgery.

What intervention was performed after failed chest drainage?

The patient underwent video-assisted thoracoscopic surgery (VATS) with bullectomy and pleurodesis after emergency drainage failed to resolve persistent air leakage.

What elements were included in the MRR protocol and what outcomes were observed?

The MRR protocol included airway clearance techniques, inspiratory muscle training, breathing pattern adjustment, supervised cough training, positioning, bed mobility and thrombosis prevention, gradual reintegration of the affected lung, and early mobilization. Outcomes included marked improvement in pulmonary function (FEV1 increase) and doubled activities of daily living scores, leading to independent community living.

Sep 28, 2026

Uploaded by Dipper