Comentario sobre el artículo "Rehabilitación intrahospitalaria en el paciente con Covid-19" / Comment about the article"In -hospital rehabilitation in patients with Covid-19

La pandemia por Covid-19 ha impactado la realidad mundial aumentando el requerimiento de unidades de cuidados intensivos y la necesidad de personal entrenado para atender pacientes críticos ,lo cual ha evidenciado la importancia de profesiones como la Fisioterapia en los equipos interdisciplinarios de la primera línea de atención

The Covid-19 pandemic has impacted the world reality, increasing the requirement for intensive care units and the need for trained personnel to care for critical patients, which has highlighted the importance of professions such as Physiotherapy in the interdisciplinary teams of the first line of care.

Reply to "Impact of Using a Novel Gastric Feeding Tube Adaptor on Patient's Comfort and Air Leaks During Non-invasive Mechanical Ventilation" / Réplica a "Impacto del uso de un innovador adaptador para la sonda de alimentación gástrica en la comodidad y las fugas de aire durante la ventilación mecánica no invasiva"

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Impact of Using a Novel Gastric Feeding Tube Adaptor on Patient's Comfort and Air Leaks During Non-invasive Mechanical Ventilation / Impacto del uso de un innovador adaptador para la sonda de alimentación gástrica en la comodidad y las fugas de aire durante la ventilación mecánica no invasiva

INTRODUCTION: The presence of oral or naso-enteral probes during non-invasive mechanical ventilation (NIMV) increases the risk of leakage and patient discomfort. The objective of this study was to evaluate the effectiveness of a novel tube adapter for NIMV (TA-NIMV) in relation to leakage and comfort level. METHODS: A non-randomized quasi-experimental design was performed in an adult intensive care unit of a highly complex hospital, in which patients were their own controls. We included adult patients who required NIV with oronasal mask and who simultaneously had oral or naso-enteric tubes. The interventions were as follows: every participant received two therapies, one with the TA-NIMV and one conventional therapy of NIMV (CT-NIMV). Comfort could be evaluated in 99 patients with a Glasgow Coma Scale of 15. The outcomes of interest was the average percentage of air leak and patient comfort during each intervention. RESULTS: 196 patients were included in the study during a 16-month period. The mean air leak percentage was 9.2% [standard deviation (SD), 7.7] during TA-NIMV and 32.5% (SD, 12.5) during CT-NIMV (p < 0.001). 84.9% reported being comfortable or very comfortable during TA-VMNI. 66.7% Uncomfortable or Very uncomfortable during CT-NIMV (p < 0.001). CONCLUSION: Higher comfort levels and lower air leakage volume percentages were achieved using the TA-NIMV than those achieved by CT-NIMV

INTRODUCCIÓN: La presencia de sondas orales o nasoenterales durante la ventilación mecánica no invasiva (VMNI) incrementa el riesgo de fugas y la incomodidad del paciente. El objetivo de este estudio fue evaluar la efectividad de un novedoso adaptador de sondas para VMNI (AS-VMNI) en relación con las fugas y nivel de comodidad. MÉTODOS: Se realizó un diseño cuasiexperimental no aleatorizado en la unidad de cuidados intensivos del adulto de un hospital de alta complejidad, en el cual los pacientes fueron sus propios controles. Se incluyeron pacientes adultos que requerían VMNI con máscara oronasal y que tenían simultáneamente sondas orales o nasoenterales. Cada participante recibió 2 tratamientos: uno con el AS-VMNI y otro, convencional, con VMNI (CT-NIMV). La comodidad pudo evaluarse en 99 pacientes con un 15 en la escala de coma de Glasgow. Las variables de resultado fueron el porcentaje de fugas y la comodidad del paciente durante cada una de las intervenciones. RESULTADOS: Ciento noventa y seis pacientes fueron incluidos en el estudio durante un período de 16 meses. El porcentaje medio de fuga de aire fue del 9,2% (desviación estándar, 7,7) durante el AS-VMNI y del 32,5% (desviación estándar, 12,5) durante el TC-VMNI (p < 0,001). El 84,9% de los pacientes refirieron sentirse cómodos o muy cómodos durante AS-VMNI. El 66,7% refirieron estar incómodos o muy incómodos durante TC-NIMV (p < 0,001). CONCLUSIÓN: El uso del AS-VMNI permitió mayores niveles de comodidad y menores porcentajes de fugas de aire que con el TC-VMNI

Impact of Using a Novel Gastric Feeding Tube Adaptor on Patient's Comfort and Air Leaks During Non-invasive Mechanical Ventilation.

INTRODUCTION: The presence of oral or naso-enteral probes during non-invasive mechanical ventilation (NIMV) increases the risk of leakage and patient discomfort. The objective of this study was to evaluate the effectiveness of a novel tube adapter for NIMV (TA-NIMV) in relation to leakage and comfort level. METHODS: A non-randomized quasi-experimental design was performed in an adult intensive care unit of a highly complex hospital, in which patients were their own controls. We included adult patients who required NIV with oronasal mask and who simultaneously had oral or naso-enteric tubes. The interventions were as follows: every participant received two therapies, one with the TA-NIMV and one conventional therapy of NIMV (CT-NIMV). Comfort could be evaluated in 99 patients with a Glasgow Coma Scale of 15. The outcomes of interest was the average percentage of air leak and patient comfort during each intervention. RESULTS: 196 patients were included in the study during a 16-month period. The mean air leak percentage was 9.2% [standard deviation (SD), 7.7] during TA-NIMV and 32.5% (SD, 12.5) during CT-NIMV (p<0.001). 84.9% reported being comfortable or very comfortable during TA-VMNI. 66.7% Uncomfortable or Very uncomfortable during CT-NIMV (p<0.001). CONCLUSION: Higher comfort levels and lower air leakage volume percentages were achieved using the TA-NIMV than those achieved by CT-NIMV.