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1.
Rev Med Liege ; 76(5-6): 432-439, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080376

RESUMO

The perception of ventilatory effort is common in oncology, especially but not exclusively in the advanced stages of neoplastic disease. Dyspnea is a symptom whose discomfort and anguish it generates in the patient and his/ her entourage require constant management throughout the illness. The first step is to identify and optimize the treatment of comorbidities associated with tumour disease. Relief of respiratory oppression as a symptom requires a multidisciplinary approach. Opiates and benzodiazepines are at the forefront of pharmacological management. The mechanical obstruction that limits ventilatory flow and/or chest ampliation may justify more invasive management, including endoscopic techniques. Oxygen therapy will be considered on a case-by-case basis. Finally, global management includes respiratory revalidation, psychological support and improvement of environmental quality.


Assuntos
Dispneia , Neoplasias , Analgésicos Opioides/uso terapêutico , Ansiedade , Benzodiazepinas , Dispneia/etiologia , Dispneia/terapia , Feminino , Humanos , Neoplasias/complicações , Neoplasias/terapia
2.
Stud Health Technol Inform ; 279: 149-156, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33965933

RESUMO

Clinical decision support systems (CDSS) have been shown in a variety of diseases to lead to improvements in care. The aim of this study is to design a CDSS to assist GPs to assess and manage breathlessness, a highly prevalent symptom in practice. A focus group is conducted to explore the needs of general practitioners (GPs), assess current workflow to identify points for intervention and develop early prototypes for testing. Five GPs took part in the focus group elucidating 248 relevant data points which were then qualitatively analyzed using the Technology Acceptance Model as the theoretical framework. In general, there was a positive attitude towards the use of CDSS for breathlessness with various proposed features from the participants. Twelve high level workflow steps were identified with 5 as key points for intervention. Several proposed features such as reporting likelihood of causes of breathlessness in a patient, link with evidence-based recommendations, integration with clinical notes and patient education materials were translated into a prototype. Mixed-method studies are planned to assess its usability to inform subsequent iterations of the CDSS development.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Clínicos Gerais , Dispneia/diagnóstico , Dispneia/terapia , Humanos , Atenção Primária à Saúde , Fluxo de Trabalho
3.
BMJ Open ; 11(5): e050149, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33986071

RESUMO

OBJECTIVES: This study aimed to explore the degree to which non-pharmacological strategies for chronic breathlessness are sustained 6 months after completing a breathlessness service in patients with chronic obstructive pulmonary disease (COPD), and patient perceptions regarding the need for ongoing support. DESIGN: A qualitative approach was taken using semistructured telephone interviews. Thematic analysis used an integrative approach. SETTING: The Westmead Breathlessness Service (WBS) trains patients with COPD to self-manage chronic breathlessness over an 8-week programme with multidisciplinary input and home visits. PARTICIPANTS: Patients with moderate to very severe COPD who had completed the WBS programme 6 months earlier. RESULTS: Thirty-two participants were interviewed. One or more breathlessness self-management strategies were sustained by most participants, including breathing techniques (n=22; 69%), the hand-held fan (n=17; 53%), planning/pacing and exercise (n=14 for each; 44%) and strategic use of a four-wheeled walker (n=8; 25%). However, almost a third of participants appeared to be struggling psychologically, including some who had refused psychological intervention. A 'chaos narrative' appeared to be prevalent, and many participants had poor recall of the programme. CONCLUSIONS: Self-management strategies taught by breathlessness services to patients with moderate to very severe COPD have potential to be sustained 6 months later. However, psychological coping may be more challenging to maintain. Research is needed on ways to improve resilience to set-backs and uptake of psychological interventions, as well as to understand and address the implications of poor recall for self-management. TRIAL REGISTRATION NUMBER: ACTRN12617000499381.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Autogestão , Adaptação Psicológica , Dispneia/etiologia , Dispneia/terapia , Humanos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/terapia , Pesquisa Qualitativa
5.
Complement Ther Clin Pract ; 43: 101306, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33545575

RESUMO

PURPOSE: This study was carried out to find out the effects of yoga applied to chronic respiratory disease patients on dyspnea, sleep quality and fatigue. MATERIAL AND METHOD: The study was conducted between May and August 2020 as a randomized controlled study. 'Personal Information Form', 'Respiratory Functions Monitoring Form', 'COPD and Asthma Fatigue Scale (CAFS), "Asthma and COPD Sleep Impact Scale (CASIS)" and Modified Medical Research Council Dyspnea Scale (mMRC) were used in data collection. RESULTS: When the post-test mean scores of the patients in the experimental and control group were compared, it was found that CAFS, CASIS and mMRC mean scores of the patients in the experimental group decreased positively compared to the patients in the control group and the difference between was found to be statistically significant (p < 0.05). CONCLUSION: Yoga has been found to reduce the severity of dyspnea and fatigue and improve sleep quality in chronic respiratory diseases.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Ioga , Dispneia/terapia , Fadiga/terapia , Humanos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/terapia , Qualidade de Vida , Sono , Inquéritos e Questionários
6.
Am J Case Rep ; 22: e928421, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33542171

RESUMO

BACKGROUND High-frequency percussive ventilation (HFPV) is a method that combines mechanical ventilation with high-frequency oscillatory ventilation. This report describes 3 cases of patients with severe COVID-19 pneumonia who received intermittent adjunctive treatment with HFPV at a single center without requiring admission to the Intensive Care Unit (ICU). CASE REPORT Case 1 was a 60-year-old woman admitted to the hospital 14 days after the onset of SARS-CoV-2 infection symptoms, and cases 2 and 3 were men aged 65 and 72 years who were admitted to the hospital 10 days after the onset of SARS-CoV-2 infection symptoms. All 3 patients presented with clinical deterioration accompanied by worsening lung lesions on computed tomography (CT) scans after 21 days from the onset of symptoms. SARS-CoV-2 infection was confirmed in all patients by real-time reverse transcription-polymerase chain reaction (RT-PCR) assay from nasal swabs. All 3 patients had impending respiratory failure when non-invasive intermittent HFPV therapy was initiated. After therapy, the patients had significant clinical improvement and visibly decreased lung lesions on followup CT scans performed 4-6 days later. CONCLUSIONS The 3 cases described in this report showed that the use of intermittent adjunctive treatment with HFPV in patients with severe pneumonia due to infection with SARS-CoV-2 improved lung function and may have prevented clinical deterioration. However, recommendations on the use of intermittent HFPV as an adjunctive treatment in COVID-19 pneumonia requires large-scale controlled clinical studies. In the pandemic context, with a shortage of ICU beds, avoiding ICU admission by using adjunctive therapies on the ward is a useful option.


Assuntos
COVID-19/terapia , Ventilação de Alta Frequência , Idoso , COVID-19/complicações , Deterioração Clínica , Tosse/terapia , Tosse/virologia , Dispneia/terapia , Dispneia/virologia , Feminino , Hospitalização , Humanos , Pulmão/diagnóstico por imagem , Pulmão/virologia , Masculino , Pessoa de Meia-Idade , Oxigenoterapia , Insuficiência Respiratória/prevenção & controle , Tomografia Computadorizada por Raios X
8.
Trials ; 22(1): 22, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407792

RESUMO

BACKGROUND: Recently, a large group of patients with persistent dyspnea, poor physical capacity, and reduced health-related quality of life (HRQoL) following pulmonary embolism (PE) has been identified and clustered under the name "post pulmonary embolism syndrome" (PPS). These patients seem good candidates for pulmonary rehabilitation. The aim of the study is to explore whether a pulmonary rehabilitation program can improve physical capacity, dyspnea, and HRQoL in PPS patients. METHODS: A two-center randomized controlled trial (RCT) is being performed at Østfold Hospital and Akershus University Hospital in Norway. Patients with PPS are 1:1 randomized into an intervention or a control group. The intervention consists of a supervised, outpatient rehabilitation program twice weekly (1 h) for 8 weeks provided by experienced physiotherapists. The intervention involves individually adapted exercises based on existing pulmonary rehabilitation programs (relaxation, interval, and resistance training), and an educational session including topics such as normal anatomy and physiology of the respiratory and circulatory system, information on PE/PPS, breathing strategies, and benefits of exercise/physical activity. Patients randomized to the control group receive usual care without specific instructions to exercise. Participants in the intervention and control groups will be compared based on assessments conducted at baseline, 12 weeks, and 36 weeks after inclusion using the incremental shuttle walk test (primary outcome) and endurance shuttle walk test (exercise capacity), Sensewear activity monitor (daily physical activity), the modified Medical Research Council scale, the Shortness of Breath Questionnaire (dyspnea), and EQ-5D-5L and the Pulmonary Embolism Quality of Life Questionnaire (HRQoL). Recruitment of 190 patients is currently ongoing. DISCUSSION: Results from this study may provide a currently untreated group of PPS patients with an effective treatment resulting in reduced symptoms of dyspnea, improved exercise capacity, and better HRQoL following PE. TRIAL REGISTRATION: Clinical Trials NCT03405480 . Registered prospectively on September 2017. Protocol version 1 (from original protocol September 2017). The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 1).


Assuntos
Embolia Pulmonar , Qualidade de Vida , Dispneia/diagnóstico , Dispneia/etiologia , Dispneia/terapia , Terapia por Exercício , Humanos , Noruega , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
J Gen Intern Med ; 36(4): 1035-1040, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33469757

RESUMO

Internists frequently care for patients who suffer from breathlessness in both the inpatient and the outpatient settings. Patients may experience chronic refractory breathlessness despite thorough evaluation and management of their underlying medical illnesses. Left unmanaged, chronic breathlessness is associated with worsened quality of life, more frequent visits to the emergency room, and decreased activity levels, as well as increased levels of depression and anxiety. This narrative review summarizes recent research on interventions for the relief of breathlessness, including both non-pharmacologic and pharmacologic options.


Assuntos
Médicos , Qualidade de Vida , Ansiedade , Doença Crônica , Dispneia/diagnóstico , Dispneia/epidemiologia , Dispneia/terapia , Humanos
11.
Chest ; 159(1): e35-e38, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33422238

RESUMO

CASE PRESENTATION: A 28-year-old man presented with shortness of breath, chest pain, and scant hemoptysis. Three weeks previously, he was admitted for coronavirus disease 2019 pneumonia that had been diagnosed by nasal swab polymerase chain reaction. Chest CT imaging demonstrated bilateral ground-glass opacities without evidence of VTE. He was treated with hydroxychloroquine, up to 7 L/min oxygen, and self-proning. After 8 days of hospitalization, he was discharged on 4 L/min oxygen. After discharge, his symptoms and hypoxia resolved.


Assuntos
COVID-19/complicações , Dor no Peito/etiologia , Dispneia/etiologia , Hemoptise/etiologia , Adulto , Dor no Peito/terapia , Dispneia/terapia , Hemoptise/terapia , Humanos , Masculino
12.
Sci Rep ; 11(1): 2256, 2021 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-33500431

RESUMO

Patients suffering from CVOID-19 mostly experience a benign course of the disease. Approximately 14% of SARS-CoV2 infected patients are admitted to a hospital. Cohorts exhibiting severe lung failure in the form of acute respiratory distress syndrome (ARDS) have been well characterized. Patients without ARDS but in need of supplementary oxygen have received much less attention. This study describes the diagnosis, symptoms, treatment and outcomes of hospitalized patients with COVID-19 needing oxygen support during their stay on regular ward. All 133 patients admitted to the RWTH Aachen university hospital with the diagnosis of COVID-19 were included in an observational registry. Clinical data sets were extracted from the hospital information system. This analysis includes all 57 patients requiring supplemental oxygen not admitted to the ICU. 57 patients needing supplemental oxygen and being treated outside the ICU were analyzed. Patients exhibited the typical set of symptoms for COVID-19. Of note, hypoxic patients mostly did not suffer from clinically relevant dyspnea despite oxygen saturations below 92%. Patients had fever for 7 [2-11] days and needed supplemental oxygen for 8 [5-13] days resulting in an overall hospitalization time of 12 [7-20] days. In addition, patients had persisting systemic inflammation with CRP levels remaining elevated until discharge or death. This description of COVID-19 patients requiring oxygen therapy should be taken into account when planning treatment capacity. Patients on oxygen need long-term inpatient care.


Assuntos
COVID-19/terapia , Oxigenoterapia/métodos , Oxigênio/uso terapêutico , Síndrome do Desconforto Respiratório/terapia , Síndrome do Desconforto Respiratório/virologia , Idoso , Idoso de 80 Anos ou mais , Dispneia/terapia , Feminino , Hospitalização , Humanos , Hipóxia/terapia , Inflamação , Pacientes Internados , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pessoa de Meia-Idade , RNA Viral , Sistema de Registros
13.
FP Essent ; 498: 11-20, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33166102

RESUMO

As the health status of patients living with multiple chronic conditions declines, these patients experience a variety of symptoms (eg, respiratory, gastrointestinal, psychological symptoms; overall symptoms of decline; and pain). Respiratory symptoms can include dyspnea, cough, and excessive upper respiratory tract secretions. Gastrointestinal symptoms can include nausea and vomiting, constipation, and malignant bowel obstruction. Overall symptoms include anorexia, cachexia, and fatigue. Psychological symptoms may manifest as depression, anxiety, or delirium. For patients with chronic pain and progressive disease, it is important to identify the etiology and type of pain (ie, visceral, somatic, neuropathic) because management differs. An evaluation of total pain should consider the various domains of suffering, including physical, psychological, and spiritual suffering. It is imperative to attempt to identify the underlying causes of the symptoms and address it if possible. It also is important to relieve symptoms using nonpharmacologic and pharmacologic approaches. In patients unable to self-report symptoms, family members and/or caregivers can provide insight into the condition of the patient.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Assistência Terminal , Dispneia/etiologia , Dispneia/terapia , Humanos , Náusea/terapia , Cuidados Paliativos , Vômito/terapia
14.
JAMA Netw Open ; 3(9): e2022310, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32965502

RESUMO

Importance: Identifying independent risk factors for adverse outcomes in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can support prognostication, resource utilization, and treatment. Objective: To identify excess risk and risk factors associated with hospitalization, mechanical ventilation, and mortality in patients with SARS-CoV-2 infection. Design, Setting, and Participants: This longitudinal cohort study included 88 747 patients tested for SARS-CoV-2 nucleic acid by polymerase chain reaction between Feburary 28 and May 14, 2020, and followed up through June 22, 2020, in the Department of Veterans Affairs (VA) national health care system, including 10 131 patients (11.4%) who tested positive. Exposures: Sociodemographic characteristics, comorbid conditions, symptoms, and laboratory test results. Main Outcomes and Measures: Risk of hospitalization, mechanical ventilation, and death were estimated in time-to-event analyses using Cox proportional hazards models. Results: The 10 131 veterans with SARS-CoV-2 were predominantly male (9221 [91.0%]), with diverse race/ethnicity (5022 [49.6%] White, 4215 [41.6%] Black, and 944 [9.3%] Hispanic) and a mean (SD) age of 63.6 (16.2) years. Compared with patients who tested negative for SARS-CoV-2, those who tested positive had higher rates of 30-day hospitalization (30.4% vs 29.3%; adjusted hazard ratio [aHR], 1.13; 95% CI, 1.08-1.13), mechanical ventilation (6.7% vs 1.7%; aHR, 4.15; 95% CI, 3.74-4.61), and death (10.8% vs 2.4%; aHR, 4.44; 95% CI, 4.07-4.83). Among patients who tested positive for SARS-CoV-2, characteristics significantly associated with mortality included older age (eg, ≥80 years vs <50 years: aHR, 60.80; 95% CI, 29.67-124.61), high regional COVID-19 disease burden (eg, ≥700 vs <130 deaths per 1 million residents: aHR, 1.21; 95% CI, 1.02-1.45), higher Charlson comorbidity index score (eg, ≥5 vs 0: aHR, 1.93; 95% CI, 1.54-2.42), fever (aHR, 1.51; 95% CI, 1.32-1.72), dyspnea (aHR, 1.78; 95% CI, 1.53-2.07), and abnormalities in the certain blood tests, which exhibited dose-response associations with mortality, including aspartate aminotransferase (>89 U/L vs ≤25 U/L: aHR, 1.86; 95% CI, 1.35-2.57), creatinine (>3.80 mg/dL vs 0.98 mg/dL: aHR, 3.79; 95% CI, 2.62-5.48), and neutrophil to lymphocyte ratio (>12.70 vs ≤2.71: aHR, 2.88; 95% CI, 2.12-3.91). With the exception of geographic region, the same covariates were independently associated with mechanical ventilation along with Black race (aHR, 1.52; 95% CI, 1.25-1.85), male sex (aHR, 2.07; 95% CI, 1.30-3.32), diabetes (aHR, 1.40; 95% CI, 1.18-1.67), and hypertension (aHR, 1.30; 95% CI, 1.03-1.64). Notable characteristics that were not significantly associated with mortality in adjusted analyses included obesity (body mass index ≥35 vs 18.5-24.9: aHR, 0.97; 95% CI, 0.77-1.21), Black race (aHR, 1.04; 95% CI, 0.88-1.21), Hispanic ethnicity (aHR, 1.03; 95% CI, 0.79-1.35), chronic obstructive pulmonary disease (aHR, 1.02; 95% CI, 0.88-1.19), hypertension (aHR, 0.95; 95% CI, 0.81-1.12), and smoking (eg, current vs never: aHR, 0.87; 95% CI, 0.67-1.13). Most deaths in this cohort occurred in patients with age of 50 years or older (63.4%), male sex (12.3%), and Charlson Comorbidity Index score of at least 1 (11.1%). Conclusions and Relevance: In this national cohort of VA patients, most SARS-CoV-2 deaths were associated with older age, male sex, and comorbidity burden. Many factors previously reported to be associated with mortality in smaller studies were not confirmed, such as obesity, Black race, Hispanic ethnicity, chronic obstructive pulmonary disease, hypertension, and smoking.


Assuntos
Causas de Morte , Infecções por Coronavirus , Hospitalização , Pandemias , Pneumonia Viral , Respiração Artificial , Veteranos , Idoso , Betacoronavirus , Estudos de Coortes , Comorbidade , Coronavirus , Infecções por Coronavirus/sangue , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Dispneia/etiologia , Dispneia/terapia , Feminino , Febre/etiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Pneumonia Viral/virologia , Modelos de Riscos Proporcionais , Fatores de Risco , Síndrome Respiratória Aguda Grave , Índice de Gravidade de Doença , Estados Unidos , United States Department of Veterans Affairs
16.
Med. paliat ; 27(3): 171-180, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197370

RESUMO

La pandemia por SARS-CoV-2 que expuso a nuestros pacientes a una importante carga sintomática hizo de los cuidados paliativos una herramienta necesaria para la atención de estos pacientes. Los fármacos empleados para contrarrestar el virus y los tratamientos para el control de síntomas tienen múltiples interacciones debido tanto al hepatotrofismo del virus como a las vías de metabolismo de los tratamientos. Con este artículo pretendemos compartir nuestra experiencia y algunas recomendaciones farmacológicas para minimizar potenciales interacciones y efectos secundarios de los tratamientos empleados. Queda mucho por investigar, pero creemos que compartiendo información entre centros podremos brindar el mejor abordaje multidisciplinar que merecen los pacientes


The SARS-CoV-2 pandemic that exposed our patients to a significant symptom burden made palliative care a necessary tool for the care of these patients. The drugs used to counteract the virus and the treatments used for the control of symptoms have multiple interactions due to both the hepatotrophism of the virus and the metabolism pathways of treatments. With this article we aim to share our experience and some pharmacological recommendations to minimize the potential interactions and side effects of treatments. Much remains to be investigated but we believe that by sharing information between centers we shall be able to provide the best multidisciplinary approach that patients deserve


Assuntos
Humanos , Neoplasias Hematológicas/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/terapia , Cuidados Paliativos/métodos , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Betacoronavirus/efeitos dos fármacos , Sistemas de Medicação/normas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Pandemias , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Manejo da Dor , Dispneia/terapia , Tosse/terapia
17.
PLoS One ; 15(8): e0237973, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853275

RESUMO

INTRODUCTION: Exercise modalities offered as part of traditional pulmonary rehabilitation (PR) do not always translate to successful performance of Activities of Daily Living (ADL) and may hinder gains in patient's sense of well-being. Data is lacking on the efficacy of incorporation of ADL-focused training in PR. The aim of this study was to determine the impact of incorporation of ADL simulation and energy-conservation training in PR as part of a quality-initiative on health-related-quality-of-life (HRQOL), dyspnea, fatigue, and six-minute-walk-test among PR patients. METHODS: Retrospective study where medical records of consecutive patients with chronic respiratory diseases who completed PR from 2016 to 2018 were reviewed. ADL-focused energy-conservation training was added to traditional PR in September 2017 by replacing three monthly sessions of traditional PR with energy-conservation training as a quality-improvement-initiative. The change from baseline on HRQOL measured by COPD assessment test (CAT), six-minute-walk-test, MMRC dyspnea score and CRQ-dyspnea and CRQ-fatigue questionnaires, were compared between patients who received traditional PR versus energy-conservation PR. Within and between group differences were calculated via repeated-measures ANOVA. RESULTS: The baseline characteristics of 91 patients who participated in traditional PR versus energy-conservation PR (n = 85) were similar (mean age = 68.6±10.4 years, 49% men). While improvement from baseline was similar and significant for both groups for MMRC, CRQ-dyspnea and CRQ-fatigue scores, and six-minute walk test, patients who participated in energy-conservation PR had significantly higher improvement in HRQOL CAT scores (p = 0.01) than those who completed traditional PR. CONCLUSION: Tailoring patient's training programs to include energy-conservation training exercises specific to ADL in PR improved HRQOL over traditional PR in patients with chronic respiratory diseases despite no significant change in functional status. Future randomized-controlled trials will be needed to confirm these initial findings.


Assuntos
Atividades Cotidianas , Dispneia/terapia , Terapia por Exercício , Qualidade de Vida , Idoso , Dispneia/complicações , Dispneia/fisiopatologia , Dispneia/reabilitação , Feminino , Humanos , Masculino , Doença Pulmonar Obstrutiva Crônica/complicações , Inquéritos e Questionários , Caminhada
18.
Trials ; 21(1): 751, 2020 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-32854761

RESUMO

BACKGROUND: In December 2019, pneumonia associated with the 2019 novel coronavirus (COVID-19) emerged in Wuhan, China. The number of cases has increased rapidly. Patients with severe disease have a poor prognosis, and there are no effective therapies for COVID-19. Only rapid advice guidelines for symptomatic supportive care have been used. A traditional Chinese medicine rehabilitation (TCMR) program consisting of acupressure therapy and Liu Zi Jue Qigong can be used as a complementary therapy for COVID-19. Hence, we designed a randomized trial to evaluate the efficacy and advantages of TCMR for treating patients with severe COVID-19. METHODS/DESIGN: This is a parallel-design, two-arm, analyst assessor-blinded, randomized controlled trial. A total of 128 patients with COVID-19 aged from 20 to 80 years will be recruited and assigned randomly into a guideline therapy group and a guideline therapy plus TCMR group at a 1:1 ratio. Patients in both groups will receive guideline therapy. The patients in the intervention group will perform acupressure therapy and Liu Zi Jue Qigong exercises in addition to conventional treatments twice a day and will be persistent from admission to discharge. The primary outcome will be measured with the Modified Medical Research Council Dyspnea Scale, and the secondary outcomes will include the Activities of Daily Living Barthel Index Scale, Patient Health Questionnaire-9 Scale, and the Respiratory Symptoms Scale. The assessments of the clinical scales will be performed at three points (before treatment, the 7th day during hospitalization, and the discharge day). Adverse events will be noted and recorded for the safety evaluation. DISCUSSION: This trial will provide high-quality evidence of the value of TCMR, which consists of acupressure therapy and Liu Zi Jue Qigong exercises, for treating patients with severe COVID-19. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000029994 . Registered on 18 February 2020.


Assuntos
Acupressão/métodos , Infecções por Coronavirus/terapia , Dispneia/terapia , Pneumonia Viral/terapia , Qigong/métodos , Atividades Cotidianas , Betacoronavirus , Terapias Complementares , Infecções por Coronavirus/fisiopatologia , Dispneia/fisiopatologia , Humanos , Medicina Tradicional Chinesa , Pandemias , Questionário de Saúde do Paciente , Pneumonia Viral/fisiopatologia , Qualidade de Vida
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