The Effects of Early Rehabilitation in the Intensive Care Unit for Patients with Severe COVID-19 Pneumonia: A Retrospective Cohort Study

Kinoshita, Tokio; Nishimura, Yukihide; Umemoto, Yasunori; Fujita, Yasuhisa; Kouda, Ken; Yasuoka, Yoshinori; Kyo, Michihito; Kato, Seiya; Tajima, Fumihiro

doi:10.3390/jcm11020357

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Long-term physical, cognitive and psychosocial consequences have been identified in ICU survivors from the CARDS. Several authors pleaded for the implementation of early rehabilitation in mechanically ventilated patients with CARDS [19][20][21]. Stutz et al demonstrated the feasibility of implementing physical and occupational therapy in a population of critically ill COVID-19 patients [20].…”

Section: Discussionmentioning

confidence: 99%

Early Intensive Physical Rehabilitation Combined with a Protocolized Decannulation Process in Tracheostomized Survivors from Severe COVID-19 Pneumonia with Chronic Critical Illness

Lemyze

Komorowski

Mallat

et al. 2022

JCM

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(1) Background: Intensive care unit (ICU) survivors from severe COVID-19 acute respiratory distress syndrome (CARDS) with chronic critical illness (CCI) may be considered vast resource consumers with a poor prognosis. We hypothesized that a holistic approach combining an early intensive rehabilitation with a protocol of difficult weaning would improve patient outcomes (2) Methods: A single-center retrospective study in a five-bed post-ICU weaning and intensive rehabilitation center with a dedicated fitness room specifically equipped to safely deliver physical activity sessions in frail patients with CCI. (3) Results: Among 502 CARDS patients admitted to the ICU from March 2020 to March 2022, 50 consecutive tracheostomized patients were included in the program. After a median of 39 ICU days, 25 days of rehabilitation were needed to restore patients’ autonomy (ADL, from 0 to 6; p < 0.001), to significantly improve their aerobic capacity (6-min walking test distance, from 0 to 253 m; p < 0.001) and to reduce patients’ vulnerability (frailty score, from 7 to 3; p < 0.001) and hospital anxiety and depression scale (HADS, from 18 to 10; p < 0.001). Forty-eight decannulated patients (96%) were discharged home. (4) Conclusions: A protocolized weaning strategy combined with early intensive rehabilitation in a dedicated specialized center boosted the physical and mental recovery.

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Section: Discussionmentioning

confidence: 99%

Early Intensive Physical Rehabilitation Combined with a Protocolized Decannulation Process in Tracheostomized Survivors from Severe COVID-19 Pneumonia with Chronic Critical Illness

Lemyze

Komorowski

Mallat

et al. 2022

JCM

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“…Já nos pacientes em ventilação mecânica, apesar fraqueza adquirida na UTI, falha no desmame e disfagia pós extubação, a mobilização precoce pode ser iniciada de forma lenta e progressiva, seguindo-se protocolos de despertar e respiração e monitoramento (EGGMANN et al, 2020). A reabilitação precoce surge com potencial para os pacientes com COVID internados em UTI, reduzindo, conforme evidenciados também nos estudos acima, o tempo em ventilação mecânica, internação hospitalar, e bem como a otimização nas atividades de vida funcionais (KINOSHITA et al, 2022).…”

Section: Objetivos Da Terapiaunclassified

“…Grande parte dos casos eram representados por doença leve, cerca de 80%. Aos demais, 20% precisavam de intervenção e 5% eram internados com demandas para unidade de terapia intensiva (KINOSHITA et al, 2022).…”

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Repercussões Das Intervenções De Mobilização Precoce Em Terapia Intensiva Na Covid-19: Uma Revisão Integrativa

Xavier¹,

Arrais²,

Santos³

et al. 2023

Ciências Da Saúde: Inovação, Pesquisa E Demandas Populares, Volume 4

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Objetivo: evidenciar na literatura o que é discutido sobre as repercussões da mobilização precoce pela Fisioterapia nos pacientes com COVID-19 Metodologia: Trata-se de uma revisão integrativa da literatura. O levantamento bibliográfico ocorreu entre janeiro a março de 2022. A pesquisa foi realizada por um único avaliador em três bases de dados eletrônicas: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), National Library of Medicine (PUBMED) e Physiotherapy Evidence Database (PEDRO). Com base no acrônimo PICo para pesquisas não-clínicas buscou-se responder a seguinte pergunta norteadora: o que evidencia na literatura em discussão sobre as repercussões da mobilização precoce pela Fisioterapia nos pacientes com COVID-19? Resultados: Foram encontrados 360 artigos, incluídos três trabalhos por atender os critérios exigidos pela presente revisão. Conclusão: O manejo precoce e a mobilização pela fisioterapia se mostram com benefícios em diversos níveis da doença podendo-se evidenciar diminuindo o tempo de internação hospitalar, tempo de intubação, e ganhos para realização de atividades. As limitações do estudo se mostram pelo número reduzido de artigos que abordam a temática, havendo, portanto, a necessidade de mais estudo sobre o tema para uma melhor discussão.

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“…Furthermore, Kinoshita et al. 18 ) and Sakai et al. 19 ) demonstrated the importance of early rehabilitation therapy for patients with severe COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Activity of Daily Living and Walking Ability of Patients with Severe COVID-19 at Discharge from an Acute Care Hospital

Uehara,

Harada,

Ogawa

et al. 2024

PRM

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Objectives: The effectiveness of acute rehabilitation treatment for severe coronavirus disease 2019 (COVID-19) has not yet been established. This study examined the efficacy of treatment provided to patients with severe COVID-19 in an acute care facility. Methods: A total of 98 patients with severe COVID-19 requiring inpatient management in our intensive care unit (ICU) were included between December 2020 and October 2021. They were divided into two groups: those who received physiotherapy (PT group; n=44) and those who did not receive physiotherapy (non-PT group; n=54). Their backgrounds, clinical characteristics, and activities of daily life (ADL) at discharge were compared to examine factors that influenced the need for physiotherapy (PT). We also evaluated the effect of PT on ADL by comparing the Barthel Index (BI) before PT and at discharge. Results: The PT group patients were significantly older, had longer hospital and ICU stays, and used invasive mechanical ventilators (IMV) more frequently than those in the non-PT group. More patients in the non-PT group were able to walk at discharge than in the PT group. The PT group patients showed significant improvement in BI and ADL at discharge when compared with BI at the start of PT, regardless of whether an IMV was used. Conclusions: Older patients with severe COVID-19 with prolonged hospitalization or ICU stay or on an IMV are prone to a decline in ADL and may need to be considered for early PT.

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The Effects of Early Rehabilitation in the Intensive Care Unit for Patients with Severe COVID-19 Pneumonia: A Retrospective Cohort Study

Cited by 7 publications

References 25 publications

Early Intensive Physical Rehabilitation Combined with a Protocolized Decannulation Process in Tracheostomized Survivors from Severe COVID-19 Pneumonia with Chronic Critical Illness

Early Intensive Physical Rehabilitation Combined with a Protocolized Decannulation Process in Tracheostomized Survivors from Severe COVID-19 Pneumonia with Chronic Critical Illness

Repercussões Das Intervenções De Mobilização Precoce Em Terapia Intensiva Na Covid-19: Uma Revisão Integrativa

Activity of Daily Living and Walking Ability of Patients with Severe COVID-19 at Discharge from an Acute Care Hospital

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