Physiotherapy Care of Patients with Coronavirus Disease 2019 (COVID-19) - A Brazilian Experience
Renato Fraga Righetti, Mirian Akemi Onoue, F. Politi, Débora Trigo Teixeira, Patrícia Nery de Souza, Cláudia Seiko Kondo, Eliana Vieira Moderno, Igor Gutierrez Moraes, Ana Lígia Vasconcellos Maida, Laerte Pastore, Felipe Duarte Silva, Christina May Moran de Brito, Wânia Regina Mollo Baia, Wellington Pereira Yamaguti
Abstract
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. non-invasive 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.