Estratégias de mobilização e exercícios terapêuticos precoces para pacientes em ventilação mecânica por insuficiência respiratória aguda secundária à COVID-19*
Early mobilization and exercises for patients on mechanical ventilation due to acute respiratory failure secondary to COVID-19
Bruno Prata Martinez, Flávio Maciel Dias de Andrade
Resumo
O presente documento apresenta sugestões de estratégias de mobilização e exercícios terapêuticos precoces para pacientes em ventilação mecânica por insuficiência respiratória aguda secundária à COVID-19. Estas estratégias de mobilização destinadas aos pacientes internados, especialmente sob cuidados intensivos, fazem parte da rotina dos melhores hospitais do Brasil e do Mundo. Não restam dúvidas que essas estratégias são necessárias e benéficas para a maioria dos pacientes, o que, provavelmente, não deve diferir em se tratando dos pacientes com COVID-19, em virtude do alto risco para desenvolvimento da fraqueza muscular adquirida na unidade de terapia intensiva e potencial declínio funcional. Recomenda-se que, sempre que houver viabilidade clínica, recursos humanos e técnicos disponíveis, um protocolo sistemático de mobilização e/ou exercícios terapêuticos precoces seja aplicado ao paciente com COVID-19. Essa estratégia deve ser individualizada, respeitando-se os princípios da cinesioterapia e da fisiologia do exercício. Os fisioterapeutas devem utilizar todos os equipamentos de proteção individual para sua segurança, dos pacientes e da equipe.
Palavras-chave
Abstract
This paper presents recommendations for early mobilization and exercises for patients on mechanical ventilation due to acute respiratory failure secondary to COVID-19. These therapeutic strategies, which have been used mainly with hospitalized patients especially those in intensive care units are part of routine clinical practice in most of the best hospitals around the world. There is no doubt that these strategies are necessary and beneficial for most patients, which is probably true for patients with COVID-19, due to their high risk of developing intensive care unit acquired weakness and presenting with functional decline. It is recommended that whenever the patient’s condition allows and human and technical resources are available, a progressive early mobilization and/or exercises protocol is used with COVID-19 patients. This strategy should be individualized and adhere to key principles of kinesiotherapy and exercise physiology. Physiotherapists should use all required personal protective equipment for their safety as well as for the safety of patients and staff.
Keywords
Referências
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