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[心肺运动试验和肺康复在新冠后综合征中的作用]

[The role of the cardiopulmonary exercise test and pulmonary rehabilitation in long COVID-19].

作者信息

Noureddine S, Roux-Claudé P, Eberst G, Westeel V, Barnig C, Claudé F

机构信息

Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.

Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.

出版信息

Rev Mal Respir. 2023 Sep;40(7):604-622. doi: 10.1016/j.rmr.2023.05.003. Epub 2023 Jun 23.

Abstract

INTRODUCTION

Long COVID refers to persistent symptoms, lasting more than 4 weeks after acute SARS-CoV-2 infection, even though the infection itself has been successfully controlled and remedied. Patient complaints are diverse, and the underlying physiopathological mechanisms are not well understood. Dyspnea and muscle fatigue are among the most commonly reported symptoms.

STATE OF THE ART

Cardiopulmonary exercise test (CPET) has been recognized as a useful tool in investigation of unexplained dyspnea. In patients with chronic lung disease, pulmonary rehabilitation is a program designed to counteract dyspnea, to increase exercise capacity and to improve quality of life.

PERSPECTIVES

Publications on CPET and pulmonary rehabilitation are needed in order to deepen comprehension and enhance management of long-COVID-19.

CONCLUSIONS

CPET reports have shown that symptoms persisting in the aftermath of acute SARS-CoV-2 infection may be related to deconditioning, a common occurrence after ICU stay, to cardiac dysautonomia subsequent to critical infections and, finally, to dysfunctional breathing subsequent to mild infections. These findings justify pulmonary rehabilitation, which has proven to be effective regardless of the severity of the initial infection, not only immediately after hospital discharge, but also at later points in time.

摘要

引言

长期新冠指的是急性SARS-CoV-2感染后持续超过4周的症状,即便感染本身已得到成功控制和治愈。患者的症状多种多样,其潜在的生理病理机制尚未完全明确。呼吸困难和肌肉疲劳是最常报告的症状。

现状

心肺运动试验(CPET)已被公认为是研究不明原因呼吸困难的有用工具。对于慢性肺病患者,肺康复是一项旨在缓解呼吸困难、提高运动能力和改善生活质量的方案。

展望

需要有关CPET和肺康复的出版物,以加深对长期新冠的理解并加强其管理。

结论

CPET报告显示,急性SARS-CoV-2感染后持续存在的症状可能与失健有关,这在重症监护病房停留后很常见,与严重感染后的心脏自主神经功能障碍有关,最终与轻度感染后的呼吸功能障碍有关。这些发现证明了肺康复的合理性,事实证明,无论初始感染的严重程度如何,肺康复不仅在出院后立即有效,而且在以后的时间点也有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff6f/10289121/c406a2088aca/gr1_lrg.jpg

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