Abstract
Aim: This study aims to describe rehabilitation nurse interventions in Respiratory Kinesitherapy in critically ill with COVID-19 patient undergoing venovenous extra-corporeal membrane oxygenation and its response concerning to gasometric and ventilatory parameters before and after each session.
Methodology: Case study of a 63-year-old person with history of obesity and high blood pressure. Retrospective data were collected from the clinical process, referring to a 38-day ICU stay.
Results: The most performed techniques used in Respiratory Kinesitherapy by rehabilitation nurses were suctioning through closed system, vibrations, sudden decompression, selective costal openings, forced manual expiration, directed ventilation and mechanical in-exhaler. Globally, all sessions showed that there was an improvement in inspiratory and expiratory volumes, as well as in static compliance. Machanical in-exhaler was used after a week of hospital stay, after all other possible interventions were performed, and all outcomes showed global improvements, without any adverse events.
Conclusion: Implementation of structured and individualized respiratory kinesitherapy interventions can significantly benefit recovery of critical ill patients. Techniques that weren´t described for covid 19 cases were used effectively.
References
Sociedade Portuguesa de Medicina Física e Reabilitação. Plano de Atuação na Reabilitação de Doentes Admitidos na Unidade de Cuidados Intensivos por COVD-19 https://www.spci.pt/media/covid19/COVID19_Recomendacoes_SPMFR_para_doentes_UCI.pdf
Organização Mundial de Saúde. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance. 2020; 13 March (WHO/2019-nCoV/Clinical/2020.4)
Lucchini A, De Felippis C. Pelucchi G. Grasselli G. Patroniti N, Castagna L, Et al. Application of prone position in hypoxaemic patients supported by veno-venous ECMO. Intensiv Crit Care Nurs. 2018; 48, 61-68.
Budgell, B. Guidelines to the writing of case studies. J Can Chiropr Assoc. 2008; 52(4): 199 - 204
Azevedo PM, Gomes BP. Efeitos da mobilização precoce na reabilitação funcional em doentes críticos: uma revisão sistemática. Rev Enferm Ref. 2015; Série IV (5): 129-138. Disponível em: doi.org/10.12707/RIV14035
Stiller K. Physiotherapy in Intensive Care An Updated Systematic Review. Chest J. 2013; september; 144 (3): 825-47.
Machado M. Bases da Fisiologia Respiratoria: Terapia Intensiva e Reabilitação. 2 ed. Guanabara Koogan; 2018.
Mendes JJ, Mergulhão P, Froes F, Paiva JA, Gouveia J. Recomendações da Sociedade Portuguesa de Cuidados Intensivos e Grupo de Infeção e Sépsis para a abordagem do COVID-19 em medicina intensiva. Rev Bras Ter Intensiva. [Internet]. 2020 Mar [cited 2020 abril 16];32(1):2-10. Available from:: https://www.spci.pt/media/covid-19/COVID_19_R_20200416.pdf
Mesa do Colégio da Especialidade de Enfermagem de Reabilitação. Orientações covid-MCEER: Cuidados de Enfermagem de Reabilitação para pessoas com COVID-19. Ordem dos Enfermeiros. [Internet]. 2020. Available from: https://www.ordemenfermeiros.pt/media/17940/mesa-do-col%C3%A9gio-da-especialidade de-enfermagem-de-reabilita%C3%A7%C3%A3o-orienta%C3%A7%C3%B5es-covid-19.pdf
Ntoumenopoulos, G. Rehabilitation during mechanical ventilation: Review of the recent literature. Intensiv Crit Care Nurs. 2015; 31(3): 125-132.
Camillis MLF, Savi A, Rosa RG, Figueiredo M, Wickert R, Borges LGA, et al. Effects of mechanical insufflation-exsufflation on airway mucus clearance among mechanically ventilated ICU subjects. Respir Care. 2018; 63(12):1471-1477.
Cork G., Barrett N,. Ntoumenopoulos G. Justification for Chest Physiotherapy during Ultra- Protective Lung Ventilation and Extra-Corporeal Membrane Oxygenation: A Case Study Physiother. Res. Int. 2014; August; 19: 126–28.
Mendes R, Nunes M. A importância da enfermagem de reabilitação nas unidades de cuidados intensivos portuguesas. Rev Port Enferm Reabil [Internet]. 2018; Dez. V1(2):8-13.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2020 Revista Portuguesa de Enfermagem de Reabilitação
Downloads
Abstract Views | 1374 |
---|
PDF (Português (Portugal)) | 643 |
---|
HTML (Português (Portugal)) | 39 |
---|