Fisioterapia respiratória na pandemia de Covid-19

Abstract

The new coronavirus was first detected in the city of Wuhan, China, in late 2019. The virus infection causes Covid-19 and its main symptoms are fever, fatigue and dry cough, which can progress to dyspnea or, in graver cases, severe acute respiratory syndrome 1 and death. The disease spread, and on January 31, 2020, the World Health Organization declared a pandemic. Until April 25, 2020, 2,744,744 cases have been confirmed and a total of 195,707 people have died worldwide; in Brazil, the number is 58,509 cases and 4,016 deaths. So far, there is no drug treatment for Covid-19; therefore, hospital teams from the affected countries have organized themselves to deal with cases that develop the severe form of the disease. The hospital respiratory therapist in Brazil has the autonomy to define and apply the parameters of mechanical ventilation in intubated patients 2. The Brazilian Association of Cardiorespiratory Physiotherapy and Physiotherapy in Intensive Care 3 has published guidelines on Covid-19 recommending the use of ventilation mode controlled by volume or pressure and prone position when PaO2/ FiO2<150mmHg. Noninvasive ventilation (NIV) and high-flow nasal cannula, in the case of Covid-19, should not be first-line ventilation strategies. This modality has a great risk of spreading the virus due to possible failures. Moreover, the helmet-like interface is not available in Brazilian intensive care units in general. As for oxygen therapy, the use of a nasal catheter and a rebreathing mask is indicated; the use of Venturi masks and nebulization, in turn, is not recommended. These guidelines are based on evidence from countries already affected by the pandemic. As it is a new disease, scientific research in the field of physiotherapy is being conducted. In the records of clinical trials, studies are evaluating the prone position, comparing values of positive end-expiratory pressure, telerehabilitation, the use of NIV, testing if breathing exercises can prevent Covid-19 worsening and evaluating inclined postures. None of these studies will be carried out in Brazil. Physiotherapists

Impacto Emocional Da Pandemia Covid-19 Em Profissionais Do Nasf-Ab

“…Estamos vivenciando um momento de grande desafio sob o ponto de vista da saúde, a COVID-19. Doença infecciosa causada pelo novo Coronavírus da Síndrome Respiratória Aguda Grave 2 (SARS-CoV-2), cujos principais sintomas são febre, fadiga e tosse seca, que podem evoluir para dispneia ou, em casos mais graves, óbito [1][2] .…”

“…Relatada pela primeira vez na província de Wuhan na China, no final de 2019, e caracterizada pela World Health Organization (WHO) como pandemia em 31 de janeiro de 2020, a COVID-19 se configura como uma enfermidade com rápida transmissibilidade entre indivíduos que podem ser sintomáticos ou não, cujos surtos podem crescer rápido e exponencialmente 1,3 .…”

Ciencias de la salud: Oferta, acceso y uso 4

“…La situación mundial en el contexto de la pandemia por COVID-19 ha obligado a que los organismos rectores de la salud a nivel mundial estén preparados para enfrentar la atención médica de la población(Apaza et al, 2020;Escudero et al, 2020). Con el propósito de que el personal asistencial esté capacitado, se ha hecho necesario la educación médica con el empleo de herramientas tecnológicas, enfocando los esfuerzos en la fisioterapia y la salud respiratoria, como el principal aparato que se ha visto afectado en el ser humano(Mera et al, 2020;Moreno et al, 2021;Ortega et al, 2021;Pires & Telles, 2020).En tal sentido, tales actividades van enfocadas al estudiantado de los años terminales de la carrera de Terapia Física y Deportiva. Estos sujetos son los encargados en las unidades de salud hospitalarias del seguimiento de los síntomas cardio-respiratorios en pacientes, particularmente en el tratamiento de la disnea en los pacientes que padecen de COVID-19(Arbillaga et al, 2020;Pinzón-Ríos et al, 2021).…”