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I Recomenda o brasileira de fisioterapia respiratória em unidade de terapia intensiva pediátrica e neonatal I Brazilian guidelines for respiratory physiotherapy in pediatric and neonatal intensive care units

DOI: 10.1590/s0103-507x2012000200005

Keywords: Reabilita o , Terapia respiratória , Modalidades de fisioterapia , Terapia intensiva neonatal , Respira o artificial , Crian a , Rehabilitation , Respiratory therapy , Physical therapy modalities , Intensive care , neonatal , Respiration , artificial , Child

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Abstract:

Recomenda es para a atua o do fisioterapeuta em unidade de terapia intensiva pediátrica e neonatal s o fundamentais, pois esses profissionais s o responsáveis pela reabilita o de pacientes graves. A reabilita o inclui desde a avalia o e preven o de altera es cinético funcionais às interven es de tratamento (fisioterapia respiratória e/ou motora), controle e aplica o de gases medicinais, cuidados da ventila o pulmonar mecanica invasiva e n o invasiva, protocolos de desmame e extuba o, insufla o traqueal de gás, protocolo de insufla o/desinsufla o do balonete intratraqueal, aplica o de surfactante, entre outros. Com o objetivo de propiciar a recupera o do doente e seu retorno às atividades funcionais. Nesse contexto, essas recomenda es têm o objetivo de orientar os fisioterapeutas sobre algumas interven es de preven o/tratamento de fisioterapia respiratória (desobstru o das vias aéreas; reexpans o pulmonar; posicionamento no leito; aspira o das vias aéreas; inaloterapia; tosse assistida), que auxiliam no processo de reabilita o de pacientes pediátricos e neonatais em unidade de terapia intensiva em ventila o pulmonar mecanica e até 12 horas após a extuba o. Developing guidelines for the role of the physiotherapist in neonatal and pediatric intensive care units is essential because these professionals are responsible for the rehabilitation of critically ill patients. Rehabilitation includes the evaluation and prevention of functional kinetic alterations, application of treatment interventions (respiratory and/or motor physiotherapy), control and application of medical gases, care of mechanical ventilation, weaning and extubation, tracheal gas insufflation, inflation/deflation of the endotracheal cuff protocol, and surfactant application, aiming to allow patients to have a full recovery and return to their functional activities. In this article, we present guidelines that are intended to guide the physiotherapist in some of the prevention/treatment interventions in respiratory therapy (airway clearance, lung expansion, position in bed, airway suction, drug inhalation, and cough assist), which help in the rehabilitation process of newborns and children in intensive care units during mechanical ventilation and up to 12 hours following extubation.

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