Plano de Ação para Reabilitação de Doentes com COVID-19 Admitidos em Unidade de Cuidados Intensivos

Catarina Aguiar Branco, Afonso Rocha, Inês Machado Vaz, Jonathan Rios, Anabela Pinto, Ana Rolo Duarte, Ricardo Henriques, Jorge Moreira, Catarina Matos, Sonia Tizon, Enio Pestana, André Maia, Ursula Martins, Paulo Couto, Joana Silva



Texto Completo:



Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.

World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 2020 February 24. Geneve: WHO;2020.

World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 70. 2020 19 March 2020. Geneve: WHO; 2020.

Direção Geral da Saúde. COVID-19: Relatório da situação epidemiológica em Portugal 2020. Lisboa: DGS; 2020.

Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020;92:214-7.

Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet. 2020;395:689-97.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. doi: 10.1016/S0140-6736(20)30566-3.

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020 (in press). doi: 10.1001/jamainternmed.2020.0994.

Zhou P, Huang Z, Xiao Y, Huang X, Fan XG. Protecting Chinese Healthcare Workers While Combating the 2019 Novel Coronavirus. Infect Control Hosp Epidemiol. 2020;41:745-6. doi: 10.1017/ice.2020.60.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 ;323:1061-9. doi: 10.1001/jama.2020.1585.

Wang TH, Wu CP, Wang LY. Chest physiotherapy with early mobilization may improve extubation outcome in critically ill patients in the intensive care units. Clin Respir J. 2018;12:2613-21

Thomas S, Mehrholz J, Bodechtel U, Elsner B. Effect of physiotherapy on regaining independent walking in patients with intensive-care-unit-acquired muscle weakness: A cohort study. J Rehabil Med. 2019;51:797-804 Anesthesiologists WFoSo. Coronavirus - guidance for anaesthesia and perioperative care providers 2020 [accessed April] Available from:

Chinese Association of Rehabilitation M, Respiratory rehabilitation committee of Chinese Association of Rehabilitation M, Cardiopulmonary rehabilitation Group of Chinese Society of Physicai M, Rehabilitation. Recommendations for respiratory rehabilitation of COVID-19 in adult. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:E02

Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference. Crit Care Med. 2012;40:502-9.

Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother. 2020;66:73-82. doi: 10.1016/j.jphys.2020.03.011.

Conceicao T, Gonzales AI, Figueiredo F, Vieira DSR, Bundchen DC. Safety criteria to start early mobilization in intensive care units. Systematic review. Rev Bras Ter Intensiva. 2017;29:509-19.

Miranda Rocha AR, Martinez BP, Maldaner da Silva VZ, Forgiarini Junior LA. Early mobilization: Why, what for and how? Med Intensiva. 2017;41:429-36.

Mendez-Tellez PA, Nusr R, Feldman D, Needham DM. Early Physical Rehabilitation in the ICU: A Review for the Neurohospitalist. Neurohospitalist. 2012;2:96-105.

Mayer KP, Hornsby AR, Soriano VO, Lin TC, Cunningham JT, Yuan H, et al. Safety, Feasibility, and Efficacy of Early Rehabilitation in Patients Requiring Continuous Renal Replacement: A Quality Improvement Study. Kidney Int Rep. 2020;5:39-47.

Hashem MD, Nelliot A, Needham DM. Early Mobilization and Rehabilitation in the ICU: Moving Back to the Future. Respir Care. 2016;61:971-9.

Hodgson CL, Stiller K, Needham DM, Tipping CJ, Harrold M, Baldwin CE, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care. 2014;18:658.

Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38:2089-94.

Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.

Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17:271-81.

Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93:197-207.

Chartered Society of Physiotherapy. Coronavirus: Respiratory Physiotherapy On Call Guidance. [accessed March 2020]. Available from:

MacIntyre NR. The ventilator discontinuation process: an expanding evidence base. Respir Care. 2013;58:1074-86.

Ambrosino N, Janah N, Vagheggini G. Physiotherapy in critically ill patients. Rev Port Pneumol. 2011;17:283-8.

29.Jang MH, Shin MJ, Shin YB. Pulmonary and Physical Rehabilitation in Critically Ill Patients. Acute Crit Care. 2019;34:1-13.

First Affiliated Hospital ZUSoM. Handbook of COVID-19 Prevention and Treatment. 2020. [accessed March 2020] Available from:

Routsi C, Gerovasili V, Vasileiadis I, Karatzanos E, Pitsolis T, Tripodaki E, et al. Electrical muscle stimulation prevents critical illness polyneuromyopathy: a randomized parallel intervention trial. Crit Care. 2010;14:R74.

Baron, M, Pinto, M, Koepp, J, Brandenburg, C, Martins, P, Santos, A, et al. Neuromuscular Electrical Stimulation in Intensive Care Unit Patients: Integrative Review. Mod Res Inflam. 2019; 8: 11-27.

Kuyrukluyildiz U, Binici O, Kupeli I, Erturk N, Gulhan B, Akyol F, et al. What Is the Best Pulmonary Physiotherapy Method in ICU? Can Respir J. 2016; 2016:4752467.

Adler J, Malone D. Early mobilization in the intensive care unit: a systematic review. Cardiopulm Phys Ther J. 2012;23:5-13.

Direção Geral da Saúde. Prevenção e controlo de infecção por SARS-CoV2 (COVID-19). Equipamentos de Proteção individual (EPI). Lisboa: DGS; 2020

Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O'Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338-44.

Sommers J, Engelbert RH, Dettling-Ihnenfeldt D, Gosselink R, Spronk PE, Nollet F, etal. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil. 2015;29:1051-63.

Nassar Junior AP, Pires Neto RC, de Figueiredo WB, Park M. Validity, reliability and applicability of Portuguese versions of sedation- agitation scales among critically ill patients. Sao Paulo Med J. 2008;125:215-9.

De Jonghe B, Sharshar T, Lefaucheur JP, Authier FJ, Durand-Zaleski I, Boussarsar M, et al. Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA. 2002;288:2859-67.



  • Não há apontamentos.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação