<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-3023</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Enfermagem de Reabilitação]]></journal-title>
<abbrev-journal-title><![CDATA[RPER]]></abbrev-journal-title>
<issn>2184-3023</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Enfermagem de Reabilitação]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-30232020000200058</article-id>
<article-id pub-id-type="doi">10.33194/rper.2020.v3.s2.8.5796</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Cinesiterapia Respiratória no doente crítico com COVID-19: A intervenção do Enfermeiro de Reabilitação - Estudo de caso]]></article-title>
<article-title xml:lang="es"><![CDATA[Kinesiterapia respiratoria en el paciente crítico con COVID-19: intervención de enfermera de rehabilitación - Estudio de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Respiratory kinesitherapy in critically ill patients with COVID-19: The Rehabilitation Nurse's intervention - Case study]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[China]]></surname>
<given-names><![CDATA[Marco Fernando Neves]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Antunes]]></surname>
<given-names><![CDATA[Helena Isabel Bacalhau]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[Lúcia Maria Simões]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Maria de Fátima Alves Pereira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Viseu]]></surname>
<given-names><![CDATA[Maria Fernanda Jesus Simões]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pires]]></surname>
<given-names><![CDATA[Maria Helena Dias]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário de Coimbra Pólo HG ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar Universitário de Coimbra Pólo HUC ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>11</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>11</month>
<year>2020</year>
</pub-date>
<volume>3</volume>
<fpage>58</fpage>
<lpage>64</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-30232020000200058&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-30232020000200058&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-30232020000200058&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Objetivo: Este estudo tem como objetivo: descrever as intervenções do enfermeiro de reabilitação em termos de Cinesiterapia Respiratória na pessoa com COVID-19, com ventilação mecânica e em oxigenação extra-corpórea por membrana, analisando a resposta em termos de parâmetros gasométricos e ventilatórios antes e após cada sessão.  Método: Estudo de caso de uma pessoa com 63 anos, com antecedentes de obesidade e hipertensão arterial. Realizou-se colheita de dados retrospetiva de processo clínico, referente a um período de internamento em UCI de 38 dias.  Resultados:  As técnicas mais utilizadas na Cinesiterapia Respiratória foram a aspiração de secreções em circuito fechado, vibrações, descompressão brusca, aberturas costais seletivas, expiração manual forçada, ventilação dirigida e in-exsuflador mecânico. Na globalidade das sessões, verificou-se uma melhoria nos volumes inspiratórios e expiratórios, assim como melhoria na compliance estática. Começou a usar-se o in-exsuflador mecânico ao fim de uma semana de internamento, depois de se esgotarem todas as intervenções possíveis, sendo que todos osoutcomesapresentaram melhorias globais, sem eventos de adversos.  Conclusão: A implementação de intervenções de cinesiterapia respiratória estruturadas e individualizadas, podem contribuir significativamente na recuperação da pessoa em situação crítica, tendo-se usado com eficácia técnicas que não estavam descritas para casos COVID- 19.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo: Este estudio tiene como objetivo: describir las intervenciones del enfermero de rehabilitación en términos de Kinesiterapia Respiratoria en los pacientes con COVID-19 sobre ventilación mecánica y oxigenación com membrana extracorpórea, analizando la respuesta en términos de parámetros gasométricos y ventilatorios antes y después de cada sesión.  Método: Estudio de caso de un paciente de 63 años con antecedentes patológicos de obesidad y hipertensión arterial. Se recopilaron datos retrospectivos del proceso clínico, durante una permanência en UCI de 38 días.  Resultados: Las técnicas más utilizadas en Kinesiterapia Respiratoria fueron, la aspiración de secreciones en circuito cerrado, vibraciones, descompresión repentina, aberturas costales selectivas, espiración manual forzada, ventilación dirigida y in-exsuflador mecánico. En todas las sesiones, hubo una mejoria en los volúmenes inspiratorio y espiratorio, así como en la compliance estática. El in-exsuflador mecánico se inició después de una semana de hospitalización, después de agotarse todas las intervenciones posibles, siendo que todos los resultados mostraron mejoras globales, sin eventos adversos.  Conclusión: La implementación de intervenciones de kinesiterapia respiratoria estructuradas e individualizadas puede contribuir significativamente en la recuperación de un paciente en una situación crítica, habiendo sido utilizadas técnicas que aín no se han descrito para los casos de COVID-19 de manera efectiva.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Aim: This study aims to describe rehabilitation nurse interventions in Respiratory Kinesitherapy in critically ill with COVID-19 patient undergoing venovenous extra-corporeal membrane oxygenation and its response concerning to gasometric and ventilatory parameters before and after each session.  Methodology: Case study of a 63-year-old person with history of obesity and high blood pressure. Retrospective data were collected from the clinical process, referring to a 38-day ICU stay.  Results: The most performed techniques used in Respiratory Kinesitherapy by rehabilitation nurses were suctioning through closed system, vibrations, sudden decompression, selective costal openings, forced manual expiration, directed ventilation and mechanical in-exhaler. Globally, all sessions showed that there was an improvement in inspiratory and expiratory volumes, as well as in static compliance. Machanical in-exhaler was used after a week of hospital stay, after all other possible interventions were performed, and all outcomes showed global improvements, without any adverse events. Conclusion: Implementation of structured and individualized respiratory kinesitherapy interventions can significantly benefit recovery of critical ill patients. Techniques that weren´t described for covid 19 cases were used effectively.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Cinesiterapia Respiratória]]></kwd>
<kwd lng="pt"><![CDATA[COVID-19]]></kwd>
<kwd lng="pt"><![CDATA[ventilação mecânica]]></kwd>
<kwd lng="pt"><![CDATA[Enfermeiro Reabilitação]]></kwd>
<kwd lng="pt"><![CDATA[ECMO-VV]]></kwd>
<kwd lng="pt"><![CDATA[in-exsuflador mecânico]]></kwd>
<kwd lng="es"><![CDATA[Kinesiterapia Respiratoria]]></kwd>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[Ventilacion mecanica]]></kwd>
<kwd lng="es"><![CDATA[Enfermero de rehabilitación]]></kwd>
<kwd lng="es"><![CDATA[ECMO]]></kwd>
<kwd lng="es"><![CDATA[in-exsuflador mecánico]]></kwd>
<kwd lng="en"><![CDATA[Respiratory Kinesitherapy]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[mechanical ventilation]]></kwd>
<kwd lng="en"><![CDATA[Rehabilitation Nurse]]></kwd>
<kwd lng="en"><![CDATA[ECMO-VV]]></kwd>
<kwd lng="en"><![CDATA[mechanical in-exhaler]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<collab>Sociedade Portuguesa de Medicina Física e Reabilitação</collab>
<source><![CDATA[Plano de Atuação na Reabilitação de Doentes Admitidos na Unidade de Cuidados Intensivos por COVD-19]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<collab>Organização Mundial de Saúde</collab>
<article-title xml:lang=""><![CDATA[Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected]]></article-title>
<source><![CDATA[Interim guidance]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lucchini]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[De Felippis]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Application of prone position in hypoxaemic patients supported by veno-venous ECMO]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Pelucchi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Grasselli]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Patroniti]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Castagna]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Intensiv Crit Care Nurs]]></source>
<year>2018</year>
<volume>48</volume>
<page-range>61-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Budgell]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines to the writing of case studies]]></article-title>
<source><![CDATA[J Can Chiropr Assoc]]></source>
<year>2008</year>
<volume>52</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>199-204</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Azevedo]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[BP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Efeitos da mobilização precoce na reabilitação funcional em doentes críticos: uma revisão sistemática]]></article-title>
<source><![CDATA[Rev Enferm Ref]]></source>
<year>2015</year>
<numero>5</numero>
<issue>5</issue>
<page-range>129-38</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stiller]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Physiotherapy in Intensive Care An Updated Systematic Review]]></article-title>
<source><![CDATA[Chest J]]></source>
<year>2013</year>
<volume>144</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>825-47</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Machado]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Bases da Fisiologia Respiratoria: Terapia Intensiva e Reabilitação]]></source>
<year>2018</year>
<edition>2</edition>
<publisher-name><![CDATA[Guanabara Koogan]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mendes]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mergulhão]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Froes]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Paiva]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Gouveia]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recomendações da Sociedade Portuguesa de Cuidados Intensivos e Grupo de Infeção e Sépsis para a abordagem do COVID-19 em medicina intensiva]]></article-title>
<source><![CDATA[Rev Bras Ter Intensiva]]></source>
<year>2020</year>
<volume>32</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>2-10</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="book">
<collab>Mesa do Colégio da Especialidade de Enfermagem de Reabilitação</collab>
<source><![CDATA[Orientações covid-MCEER: Cuidados de Enfermagem de Reabilitação para pessoas com COVID-19]]></source>
<year>2020</year>
<publisher-name><![CDATA[Ordem dos Enfermeiros]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ntoumenopoulos]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rehabilitation during mechanical ventilation: Review of the recent literature]]></article-title>
<source><![CDATA[Intensiv Crit Care Nurs]]></source>
<year>2015</year>
<volume>31</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>125-32</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Camillis]]></surname>
<given-names><![CDATA[MLF]]></given-names>
</name>
<name>
<surname><![CDATA[Savi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rosa]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Wickert]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Borges]]></surname>
<given-names><![CDATA[LGA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of mechanical insufflation-exsufflation on airway mucus clearance among mechanically ventilated ICU subjects]]></article-title>
<source><![CDATA[Respir Care]]></source>
<year>2018</year>
<volume>63</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1471-7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cork]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<name>
<surname><![CDATA[Barrett]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ntoumenopoulos G. Justification for Chest Physiotherapy during Ultra- Protective Lung Ventilation and Extra-Corporeal Membrane Oxygenation: A Case Study Physiother]]></article-title>
<source><![CDATA[Res. Int]]></source>
<year>2014</year>
<volume>19</volume>
<page-range>126-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mendes]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Nunes]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A importância da enfermagem de reabilitação nas unidades de cuidados intensivos portuguesas]]></article-title>
<source><![CDATA[Rev Port Enferm Reabil]]></source>
<year>2018</year>
<volume>V1</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>8-13</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
