Feasibility of the Six-Minute Walk Test for Patients Who Have Cystic Fibrosis, Are Ambulatory, and Require Mechanical Ventilation Before Lung Transplantation.

Background And Purpose: The Six-Minute Walk Test (6MWT) is a requirement for lung transplantation evaluation by the United Network for Organ Sharing. A subset of patients being evaluated for a lung transplantation require mechanical ventilation (MV) because of respiratory failure. The 6MWT has not been validated as an outcome measure for patients dependent on MV. Literature supports alternative forms of the 6MWT, including those with an oval track or treadmill, as valid for accommodating other populations. This case report describes the use of the 6MWT for 2 patients who had cystic fibrosis and required MV before a lung transplant.

Case Description: A 34-year-old woman and a 37-year-old woman were admitted to a medical intensive care unit for exacerbation of cystic fibrosis requiring prolonged intubation and a subsequent tracheostomy. Their hospital courses were characterized by participation in early rehabilitation and variable dependence on MV. Both patients performed the 6MWT for a lung transplantation workup while dependent on MV.

Outcomes: Both patients performed the 6MWT while using portable MV and achieved a distance greater than that required for transplantation consideration and approximately 50% of the reference-based expected distance for adults who are healthy. Confounding factors included external pacing and the use of an oval track.

Discussion: The use of the 6MWT for 2 patients receiving MV appeared to be feasible. Research regarding the validity of this outcome is warranted.