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物理治疗干预措施可否用于 COVID-19 危重症患者的管理?系统评价。

Could Physical Therapy Interventions Be Adopted in the Management of Critically Ill Patients with COVID-19? A Scoping Review.

机构信息

Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.

Fisiosur I+D Research Institute, 04630 Almería, Spain.

出版信息

Int J Environ Res Public Health. 2021 Feb 8;18(4):1627. doi: 10.3390/ijerph18041627.

Abstract

As part of COVID-19 consequences, it has been estimated that 5% of patients affected by this disease will require admission to the intensive care unit (ICU), and physical therapy techniques have been implemented in patients with other conditions admitted to ICU. The aim of the present study is to summarize all the available information about the implementation of physical therapy management in critically ill patients. From three clinical guidelines already published, we performed a search in PubMed, Scopus, ScienceDirect, and CINAHL, including systematic reviews, clinical guidelines, and randomized controlled trials, among others. Data extraction was performed independently by two reviewers. Quality assessment was developed through the AMSTAR-2 tool and PEDro Scale. A narrative synthesis was performed and 29 studies were included. The information extracted has been classified into four folders: ICU environment in COVID-19 (security aspects and management of the patient), respiratory physiotherapy (general indications and contraindications, spontaneously breathing and mechanically ventilated patient approaches), positional treatment, and exercise therapy (safety aspects and progression). The implementation of physiotherapy in patients affected with COVID-19 admitted to the ICU is a necessary strategy that prevents complications and contributes to the stabilization of patients in critical periods, facilitating their recovery.

摘要

作为 COVID-19 后果的一部分,据估计,5%受该疾病影响的患者将需要入住重症监护病房(ICU),并且已经在入住 ICU 的其他疾病患者中实施了物理治疗技术。本研究的目的是总结关于在危重症患者中实施物理治疗管理的所有可用信息。从已经发表的三个临床指南中,我们在 PubMed、Scopus、ScienceDirect 和 CINAHL 中进行了检索,包括系统评价、临床指南和随机对照试验等。数据提取由两名评审员独立进行。通过 AMSTAR-2 工具和 PEDro 量表进行了质量评估。进行了叙述性综合,并纳入了 29 项研究。提取的信息分为四个文件夹:COVID-19 中的 ICU 环境(安全方面和患者管理)、呼吸物理治疗(一般适应证和禁忌证、自主呼吸和机械通气患者的方法)、体位治疗和运动治疗(安全性和进展)。在入住 ICU 的 COVID-19 患者中实施物理治疗是一项必要的策略,可以预防并发症并有助于患者在关键时期的稳定,促进其康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/875d/7915254/c7d0057ab2ad/ijerph-18-01627-g001.jpg

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