Protocolo de mobilização precoce de paciente crítico e reabilitação pós-alta hospitalar na população infantil acometida de COVID-19*
Early mobilization protocol for critical patients and rehabilitation after hospital discharge in children affected by COVID-19*
Fernanda de Cordoba Lanza, Evanirso Silva Aquino, Mayson Laércio de Araújo Sousa, Paulo Douglas de Oliveira Andrade
Resumo
Esse documento tem por objetivo apresentar recomendações para mobilização precoce e exercícios terapêuticos em pacientes pediátricos acometidos pela COVID-19, ou em suspeita da doença, no ambiente hospitalar, bem como para reabilitação pós alta. Independente da fase de tratamento, ressalta-se a extrema necessidade do uso de equipamentos de proteção individual pelo fisioterapeuta. Com o objetivo de prevenir/minimizar a fraqueza muscular adquirida na UTI, recomenda-se a utilização de protocolo de mobilização precoce baseado na mobilização funcional segura e progressiva, apropriando atividades ao nível de desenvolvimento neuropsicomotor. A reabilitação hospitalar está indicada aos pacientes na unidade de internação e a avaliação da capacidade funcional poderá ser utilizada nos pacientes mais estáveis, para conduzir a intervenção. Como a reabilitação ambulatorial presencial deve ser evitada durante a pandemia de COVID-19, recomenda-se a Telereabilitação. No entanto, ressalta-se a necessidade da primeira avaliação ser presencial para correta prescrição de treinamento e especial atenção para dispneia e dessaturação durante o telemonitoramento.
Palavras-chave
Abstract
This document aims to provide guidelines for early mobilization, and inpatient or post discharge rehabilitation in pediatric patients with COVID-19. Irrespective of the setting, the use of personal protective equipment is of utmost importance. To prevent/minimize the risk of ICU acquired weakness, it is recommended to use early mobilization based on safe and progressive functional mobilization exercises adapted to the patient’s psychomotor development stage. Inpatient rehabilitation is indicated to ward patients and functional capacity assessment may be used to guide interventions when the patient’s health condition is stable. As outpatient rehabilitation should be avoided during the COVID-19 outbreak, telerehabilitation strategies are recommended. However, it is important that the first meeting with the patient is face-to-face in order to prescribe an adequate exercise training. Special attention should be given to dyspnea and oxygen desaturation during telemonitoring.
Keywords
Referências
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