Brazilian Guidelines for Early Mobilization in Intensive Care Unit

Aquim, Esperidião Elias; Bernardo, Wanderley Marques; Buzzini, Renata; Azeredo, Nára Selaimen Gaertner de; Cunha, Laura Severo da; Damasceno, Marta Cristina Pauleti; Deucher, Rafael Alexandre de Oliveira; Duarte, Antônio Carlos Magalhães; Librelato, Juliana Thiemy; Melo-Silva, César Augusto; Nemer, Sérgio Nogueira; Silva, Sabrina Donatti Ferreira da; Verona, Cléber

doi:10.5935/0103-507x.20190084

Cited by 39 publications

(47 citation statements)

References 35 publications

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“…The exercises can be tailored for maintenance of a Borg rating of o3 (on a 10-point scale) (22). Although there are no studies specific to patients with COVID-19, classically critical patients who underwent early mobilization showed a reduction in delirium and duration of mechanical ventilation (26); thus, early mobilization should be started as soon as possible, as long as the patient presents suitable clinical conditions (27). This mobilization can include neuromuscular stimulation, therapeutic exercises, and early verticalization (28)(29)(30)(31).…”

Section: ' Exercise and Early Mobilizationmentioning

confidence: 99%

Physiotherapy Care of Patients with Coronavirus Disease 2019 (COVID-19) - A Brazilian Experience

Righetti¹,

Onoue²,

Politi³

et al. 2020

Clinics

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Some patients with coronavirus disease (COVID-19) present with severe acute respiratory syndrome, which causes multiple organ dysfunction, besides dysfunction of the respiratory system, that requires invasive procedures. On the basis of the opinions of front-line experts and a review of the relevant literature on several topics, we proposed clinical practice recommendations on the following aspects for physiotherapists facing challenges in treating patients and containing virus spread: 1. personal protective equipment, 2. conventional chest physiotherapy, 3. exercise and early mobilization, 4. oxygen therapy, 5. nebulizer treatment, 6. noninvasive ventilation and high-flow nasal oxygen, 7. endotracheal intubation, 8. protective mechanical ventilation, 9. management of mechanical ventilation in severe and refractory cases of hypoxemia, 10. prone positioning, 11. cuff pressure, 12. tube and nasotracheal suction, 13. humidifier use for ventilated patients, 14. methods of weaning ventilated patients and extubation, and 15. equipment and hand hygiene. These recommendations can serve as clinical practice guidelines for physiotherapists. This article details the development of guidelines on these aspects for physiotherapy of patients with COVID-19.

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Section: ' Exercise and Early Mobilizationmentioning

confidence: 99%

Physiotherapy Care of Patients with Coronavirus Disease 2019 (COVID-19) - A Brazilian Experience

Righetti¹,

Onoue²,

Politi³

et al. 2020

Clinics

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“…Dentro dessa realidade, cabe ressaltar que a limitação das estratégias medicamentosas relacionadas às infecções aumenta o tempo em internamento hospitalar, assim como as comorbidades associadas e a taxa de mortalidade, e assim, considerando o aumento da complexidade do paciente o tratamento torna-se mais oneroso tanto para as famílias e quanto para o sistema de saúde (Aquim et al, 2019).…”

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Análise de colonização bacteriana em copos umidificadores utilizados na oxigenoterapia em pacientes internados em um Hospital Universitário

Silva

Dias

Figueroa

et al. 2021

RSD

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Objetivo: Avaliar a segurança microbiológica da água nos copos umidificadores de pacientes em uso de oxigenoterapia e internados num Hospital Universitário do Vale do Submédio do São Francisco. Métodos: Trata-se de um estudo clínico, longitudinal, observacional envolvendo análise microbiológica da água dos umidificadores utilizados em oxigenoterapia. As amostras foram coletadas diariamente, durante um período de seis meses e analisadas pelo Laboratório de Análises Clínicas do Hospital Universitário. Para análise microbiológica, o material foi incubado a 37 °C por 48 horas em tubos contendo 5mL de Brain-Heart Infusion (BHI), depois semeado em Ágar Sangue. Foram consideradas contaminadas as amostras que apresentaram crescimento bacteriano. Para identificação das espécies bacterianas e o antibiograma, utilizou-se o sistema BD Phoenix ™ 100. Resultados: Foram considerados elegíveis 52 pacientes, totalizando 279 amostras no período do estudo, destas, 20 (7,16%) apresentaram contaminação bacteriana. Os patógenos mais incidentes foram: A. baumannii, E. cloacae, K. pneumoniae, S. epidermidis. Conclusão: Os dados obtidos permitem a adoção de estratégias mais seguras na utilização dos umidificadores da oxigenoterapia. Além disso, o conhecimento do perfil de resistência das bactérias, permite mais eficácia da terapia medicamentosa, prevenindo falhas terapêuticas.

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“…Considering the clinical conditions caused by prolonged immobility and musculoskeletal deterioration, the implementation of systematized EM protocols is of fundamental relevance for patients with COVID-19, given the growing evidence of its benefit. ( 13 , 14 ) EM helps to reduce the deleterious effects of the disease, especially on muscle and cardiopulmonary function, mobility and functionality. It is a safe and feasible practice that leads to improved muscle strength and functional recovery with improved quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…It is suggested that early rehabilitation interventions in patients with COVID-19, especially those who develop with severe muscle dysfunction, fatigue and dyspnea, ( 13 ) be initiated during hospitalization and continue in specialized rehabilitation programs after discharge in order to improve their functionality and quality of life and prevent rehospitalization.…”

Section: Introductionmentioning

confidence: 99%