Decompensated non-alcoholic steatohepatitis (NASH) Cirrhosis -effects of early mobilization in the MICU
Location
Lions Eye Center
Document Type
Poster
Start Date
28-4-2025 12:00 PM
End Date
28-4-2025 1:30 PM
Description
Purpose: This case report aims to present a complex patient with NASH cirrhosis, emphasizing the clinical features observed and the strategies and effects of early mobilization implemented to enhance understanding and inform potential treatment approaches for similar cases in the future. Methods: A 67 y.o. male with a history of NASH cirrhosis was admitted to the MICU with complaints of nausea and hematemesis. The patient required an urgent trans-jugular intrahepatic portosystemic shunt (TIPS) procedure to stop the bleeding. The patient developed refractory hepatic encephalopathy and ultimately required continuous renal replacement therapy (CRRT) and vasopressor support for continued clearance. After being extubated, this patient what cleared for physical therapy where early mobilization was implemented. Results: The patient made notable progress, improving from being unable to lift his arms or legs to ambulating 40 feet. His progress was monitored through strength testing, assistance levels, and activity levels, particularly the distance he was able to walk. Discussion: One of the primary challenges the patient faced was his overall decreased endurance and strength and therefore his decrease in functional mobility and independence. The treatment plan was designed to get the moving, with the expectation that this would lead to improved functional mobility over time.
Recommended Citation
Hijazi, Rena C., "Decompensated non-alcoholic steatohepatitis (NASH) Cirrhosis -effects of early mobilization in the MICU" (2025). School of Allied Health Professions Research Day. 10.
https://digitalscholar.lsuhsc.edu/ahrd/2025/posters/10
Decompensated non-alcoholic steatohepatitis (NASH) Cirrhosis -effects of early mobilization in the MICU
Lions Eye Center
Purpose: This case report aims to present a complex patient with NASH cirrhosis, emphasizing the clinical features observed and the strategies and effects of early mobilization implemented to enhance understanding and inform potential treatment approaches for similar cases in the future. Methods: A 67 y.o. male with a history of NASH cirrhosis was admitted to the MICU with complaints of nausea and hematemesis. The patient required an urgent trans-jugular intrahepatic portosystemic shunt (TIPS) procedure to stop the bleeding. The patient developed refractory hepatic encephalopathy and ultimately required continuous renal replacement therapy (CRRT) and vasopressor support for continued clearance. After being extubated, this patient what cleared for physical therapy where early mobilization was implemented. Results: The patient made notable progress, improving from being unable to lift his arms or legs to ambulating 40 feet. His progress was monitored through strength testing, assistance levels, and activity levels, particularly the distance he was able to walk. Discussion: One of the primary challenges the patient faced was his overall decreased endurance and strength and therefore his decrease in functional mobility and independence. The treatment plan was designed to get the moving, with the expectation that this would lead to improved functional mobility over time.