Avaliação e intervenção para a reabilitação cardiopulmonar de pacientes recuperados da COVID-19*
Evaluation and intervention for cardiopulmonary rehabilitation of COVID-19 recovered patients*
Lucas de Assis Pereira Cacau, Rafael Mesquita, Karina Couto Furlanetto, Daniel Lago Silva Borges, Luiz Alberto Forgiarini Junior, Vinicius Maldaner, Yves de Souza, Gerson Cipriano Júnior, Celso Carvalho, Ingrid Correia Nogueira, Laura Tomazi, Marlus Karsten
Resumo
Com a pandemia de COVID-19, é necessário o rápido entendimento das prováveis e graves sequelas que os pacientes sobreviventes podem desenvolver, assim como torna-se urgente traçar planos de ação para enfrentar tal situação desde o processo de alta hospitalar até a inserção em serviços de reabilitação cardiopulmonar. De acordo com recomendações internacionais, uma avaliação individualizada deve ser realizada e documentada no momento da alta, a qual deve contemplar as necessidades imediatas (controle dos sintomas como dispneia, fadiga e dor), assim como as necessidades a curto e médio prazo (melhora da função física e emocional; retorno ao trabalho; dentre outros). É aconselhável que nas primeiras semanas após a alta, o paciente seja atendido através de comunicação digital, a qual deve incluir imagem e áudio por questões de segurança. Componentes mandatórios dos programas de reabilitação cardiopulmonar incluem exercícios de força e resistência, além do trabalho da musculatura inspiratória. A abordagem educacional, é item importante no processo de tratamento. A reabilitação de doentes críticos acometidos por COVID-19 após alta hospitalar é de fundamental importância, especialmente naqueles que evoluíram com o quadro grave da doença, e que necessitaram de internação em UTI.
Palavras-chave
Abstract
With the pandemic of COVID-19, it is necessary to quickly understand the probable and serious sequelae that surviving patients may develop, as well as it is urgent to draw up action plans to face this situation, which begins from the discharge process until insertion in cardiopulmonary rehabilitation services. According to international recommendations, an individualized assessment must be performed and documented at the time of discharge, which must include immediate needs (control of symptoms such as dyspnoea, fatigue and pain), as well as short and medium term needs (improvement of physical and emotional function; return to work; among others). It is recommended that in the first weeks after discharge, supervision occurs through digital communication, which must include image and audio for security reasons. Mandatory components of cardiopulmonary rehabilitation programs include strength and endurance exercises, in addition to the inspiratory muscles work. The educational approach is also an important item in the treatment process. The rehabilitation of critically ill patients affected by COVID-19 after hospital discharge is of interest, especially in those who developed the severe condition of the disease or required ICU admission.
Keywords
Referências
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