Pulmonary rehabilitation in the intensive care unit using surface electromyography in a patient with diaphragmatic injury: A case report

Diaphragmatic injury (DI) following blunt trauma can cause pulmonary complications and increased duration of ventilator-dependent intensive care unit stay. Herein, we present a 62-year-old female patient with severe trauma who was diagnosed with liver laceration and multiple rib fractures and underwent emergency laparotomy. Extubation was attempted; however, the patient had to be reintubated due to dyspnea. After reintubation, decreased right diaphragmatic excursion was confirmed by ultrasonography and the patient was diagnosed with DI. Surface electromyographic biofeedback was performed during diaphragmatic breathing training to increase the effect of pulmonary rehabilitation. Early diagnosis of DI may be possible using ultrasonography, and the use of surface electromyographic biofeedback is suggested for pulmonary rehabilitation in critically ill trauma patients.