Salwa Kamil, Kaziród-Wolski Karol, Rębak Dorota, Sielski Janusz
Intensive Cardiac Care Unit, Świetokrzyskie Cardiology Center, 25-736 Kielce, Poland.
Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University in Kielce, 25-317 Kielce, Poland.
J Clin Med. 2025 Sep 3;14(17):6230. doi: 10.3390/jcm14176230.
: Pulmonary embolism (PE) is a life-threatening condition that frequently results in persistent exertional dyspnea, reduced exercise tolerance, and psychological distress, even after acute-phase management. Despite growing recognition of post-PE impairments, structured early rehabilitation remains underutilized. This narrative review aims to evaluate current evidence on the role, components, and outcomes of early rehabilitation strategies following acute PE. : Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, a comprehensive literature search was conducted across PubMed, Embase, Scopus, Web of Science, Google Scholar, and the Cochrane Library. Articles published between 2020 and 2025 were screened for relevance to early rehabilitation in PE patients. Inclusion criteria prioritized randomized controlled trials, prospective studies, meta-analyses, and systematic reviews. Study quality was assessed using Cochrane, Newcastle-Ottawa, and AMSTAR 2 tools. : Out of 306 records, 158 studies were included. Early pulmonary rehabilitation-including aerobic and resistance exercise, inspiratory muscle training, and psychological support-demonstrated improvements in functional capacity, dyspnea, and quality of life, without adverse effects. Supplementation with omega-3 fatty acids and vitamin D may further mitigate thromboembolic risk via anti-inflammatory pathways. However, evidence remains predominantly observational, with limited high-quality data addressing timing, dosage, and patient stratification. : Early, individualized rehabilitation appears safe and potentially beneficial in improving recovery and limiting complications after acute PE. Nonetheless, the absence of robust randomized trials underscores the urgent need for hypothesis-driven research to establish standardized, evidence-based rehabilitation protocols and guidelines tailored to risk stratification and patient phenotype, so as not to prolong recovery time and keep survivors from becoming disabled.
肺栓塞（PE）是一种危及生命的疾病，即使在急性期治疗后，也常常导致持续性运动性呼吸困难、运动耐量降低和心理困扰。尽管对PE后功能障碍的认识不断提高，但结构化的早期康复仍未得到充分利用。本叙述性综述旨在评估当前关于急性PE后早期康复策略的作用、组成部分和结果的证据。
按照系统评价和Meta分析的首选报告项目（PRISMA）方法，在PubMed、Embase、Scopus、Web of Science、谷歌学术和Cochrane图书馆进行了全面的文献检索。筛选了2020年至2025年发表的与PE患者早期康复相关的文章。纳入标准优先考虑随机对照试验、前瞻性研究、Meta分析和系统评价。使用Cochrane、纽卡斯尔-渥太华和AMSTAR 2工具评估研究质量。
在306条记录中，纳入了158项研究。早期肺康复，包括有氧运动和抗阻运动、吸气肌训练和心理支持，显示出功能能力、呼吸困难和生活质量得到改善，且无不良影响。补充ω-3脂肪酸和维生素D可能通过抗炎途径进一步降低血栓栓塞风险。然而，证据主要是观察性的，高质量数据有限，涉及时间、剂量和患者分层。
早期个体化康复在改善急性PE后的恢复和限制并发症方面似乎是安全且可能有益的。尽管如此，缺乏有力的随机试验强调了迫切需要进行假设驱动的研究，以建立针对风险分层和患者表型的标准化、循证康复方案和指南，以免延长恢复时间并防止幸存者致残。
