Disclosures: Faiz N. Tausif, MD: No financial relationships or conflicts of interest

Case Description: We describe the case of a 33-year-old male admitted to the acute rehabilitation unit with critical illness polyneuropathy (CIP) from suspected vaping-related acute respiratory failure (ARF).

Setting: Acute Inpatient Rehabilitation

Patient: 33-year-old male with history of e-cigarette use who presented with acute onset shortness of breath. Patient developed ARF requiring intubation. Presentation met criteria for suspected e-cigarette/vaping-associated lung injury (EVALI). After successful extubation, evaluation of his substantial weakness by physiatry deemed him appropriate for acute rehabilitation. Assessment/

Results: Upon presenting to acute rehabilitation, bracing was instituted to assist functional mobility considering significant weakness in wrist extensors and ankle dorsiflexors. Inability to relieve pressure warranted use of low air loss mattress which provided improved self-turn ability. Initial functional status was: moderate assist eating, dependent toileting, moderate assist transfers, moderate assist bed mobility, moderate assist locomotion. Course was complicated by pneumonia which fortunately responded to antibiotics. Despite this, he progressed and reached: Independent bed mobility, modified independent transfers, modified dependent ambulation, modified independent bathing, modified independent dressing, modified independent toileting. Patient was safely discharged home. At 1-month follow-up, EMG/NCS revealed evidence of CIP. Patient continued in structured outpatient therapy. At 4-months post-initial presentation, he was functionally at baseline and appropriate for return to work.

Discussion: Our case examines substantial progress made by a young male with confirmed CIP from suspected EVALI. Early intervention involving intensive rehabilitation in patients with CIP showed improved outcomes in completion of ADLs and mobility. Participation in a 2-1/2-week acute rehab program yielded a successful outcome whereby the patient was functionally back to his baseline and returned to work.

Conclusion: Rehabilitation of patients with critical illness polyneuropathy remains a limited area of study and more so when related to the secondary effects of EVALI. Long-term implications of rehabilitation are yet to be seen, but early evidence such as ours shows promise.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/acute-rehabilitation-of-critical-illness-polyneuropathy-after-suspected-vaping-related-respiratory-failure/