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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In the present number of <span class="elsevierStyleItalic">Medicina Intensiva</span>&#44; I have read the study&#58; &#8220;Multidisciplinary approach to the sequelae of severe COVID-19 pneumonia at discharge from Critical Care&#58; are there differences depending on the respiratory therapy used&#63;&#63;&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> with interest&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The purpose of the study was to analyze the sequelae one month and up to one year after discharge among patients that had suffered severe COVID-19 pneumonia requiring admission to the Intensive Care Unit &#40;ICU&#41;&#46; The study sample consisted of approximately 100 patients that had undergone high-flow nasal oxygen therapy or invasive mechanical ventilation&#44; with an evaluation of possible differences in perceived sequelae after discharge&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In contrast to what was expected&#44; the patients subjected to mechanical ventilation presented no differences in terms of perceived physical sequelae after hospital discharge versus those subjected to high-flow nasal oxygen therapy during admission due to severe respiratory failure in the context of COVID-19&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">According to the World Health Organization &#40;WHO&#41;&#44; &#8220;Health is a state of complete physical&#44; mental and social well-being and not merely the absence of disease or infirmity&#8221;&#46; Thus&#44; the ideal situation at discharge should be such that following a short period of recovery&#44; the patient is able to return to his or her daily activities with the fewest sequelae possible&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">However&#44; on what and on whom does the minimization of post-ICU sequelae depend upon&#63; The techniques and support measures adopted during admission&#63; Socioeconomic factors of the individual&#63; The intensity of rehabilitation in the ICU&#63; A good post-ICU convalescence period&#63; The healthcare system and its organization&#63;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Certain factors depend on the individual&#44; such as regular physical activity&#44; weight control&#44; the individual perception of sequelae and of health&#44; etc&#46; Other economic and social factors in turn impact health&#44; such as socioeconomic level and well-being&#44; but also the prevention of sequelae through an adequate rehabilitation program&#44; to avoid the impact of the techniques and treatments applied in the ICU&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The pandemic was characterized by stressed resources&#44; great teamwork&#44; and multidisciplinary efforts&#44; all with a common purpose&#46; It represented the example of a &#8220;great functional unit&#8221; in which all the professionals jointly contributed to managing the critical patient&#44; based on their own individual area of knowledge&#44; thereby affording added value&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The article combines efforts in relation to multidisciplinary work&#44; of benefit according to other studies&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> in order to address the impact of the ICU upon the functions of people&#46; Of note in the study is the evaluation of the problem of post-ICU sequelae in a multidisciplinary and proactive manner after admission&#44; with proactive follow-up of the patients&#44; from which a positive impact upon functionality can be expected&#44; in addition to an improved patient return to daily life&#44; and with the fewest sequelae possible&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Another significant point of the study is the multidimensional nature of the rehabilitation program&#44; addressing physical&#44; psychological and cognitive factors&#44; and assessing the individual in a holistic and comprehensive &#40;not only partial&#41; manner&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The study appears to record no differences in the observed sequelae according to the respiratory therapy used &#40;high-flow nasal oxygen therapy versus invasive mechanical ventilation&#41;&#46; <span class="elsevierStyleItalic">A priori</span>&#44; this finding was not to be expected&#44; since patients subjected to invasive mechanical ventilation are more seriously ill and usually suffer greater sequelae&#46; The data in this regard therefore must be viewed with caution&#46; During admission&#44; it is unclear whether early rehabilitation took place &#8211; such early measures have been shown to lessen the subsequent rehabilitation needs&#46; It is also possible that since patients requiring invasive mechanical ventilation have been more seriously ill&#44; their perception of sequelae is comparatively less intense &#8211; as has been reported in other studies on the perceived quality of life at discharge&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">From the results of the study&#44; it is seen that the patients on mechanical ventilation required more group therapy and had more functional sequelae&#46; Although significance was not reached&#44; these tendencies point to the need for further studies involving larger samples&#44; in order to consolidate the results&#46; In addition&#44; the study must be placed in the context of the pandemic&#44; in which some patients were treated outside the ICU&#44; likewise with high-flow nasal oxygen&#44; and it would be interesting to know the sequelae in this group of subjects&#44; in order to examine possible differences versus the patients admitted to the ICU&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Finally&#44; the study again places value on rehabilitation&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> multidisciplinary work and a multidimensional approach to the critical patient&#44; 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Editorial
Multidisciplinary approach to the sequelae of severe COVID-19 pneumonia at discharge from Critical Care: are there differences depending on the respiratory therapy used?
Seguimiento multidisciplinar tras el alta de UCI de las secuelas por neumonía grave COVID-19
Olga Rubio Sanchiza,b
a Servicio de Medicina Intensiva, Spain
b Althaia Xarxa Hospitalaria Universitaria de Manresa, Manresa, Spain
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        "autoresLista" => "Olga Rubio Sanchiz"
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        "titulo" => "Seguimiento multidisciplinar tras el alta de UCI de las secuelas por neumon&#237;a grave COVID-19"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In the present number of <span class="elsevierStyleItalic">Medicina Intensiva</span>&#44; I have read the study&#58; &#8220;Multidisciplinary approach to the sequelae of severe COVID-19 pneumonia at discharge from Critical Care&#58; are there differences depending on the respiratory therapy used&#63;&#63;&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> with interest&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The purpose of the study was to analyze the sequelae one month and up to one year after discharge among patients that had suffered severe COVID-19 pneumonia requiring admission to the Intensive Care Unit &#40;ICU&#41;&#46; The study sample consisted of approximately 100 patients that had undergone high-flow nasal oxygen therapy or invasive mechanical ventilation&#44; with an evaluation of possible differences in perceived sequelae after discharge&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In contrast to what was expected&#44; the patients subjected to mechanical ventilation presented no differences in terms of perceived physical sequelae after hospital discharge versus those subjected to high-flow nasal oxygen therapy during admission due to severe respiratory failure in the context of COVID-19&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">According to the World Health Organization &#40;WHO&#41;&#44; &#8220;Health is a state of complete physical&#44; mental and social well-being and not merely the absence of disease or infirmity&#8221;&#46; Thus&#44; the ideal situation at discharge should be such that following a short period of recovery&#44; the patient is able to return to his or her daily activities with the fewest sequelae possible&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">However&#44; on what and on whom does the minimization of post-ICU sequelae depend upon&#63; The techniques and support measures adopted during admission&#63; Socioeconomic factors of the individual&#63; The intensity of rehabilitation in the ICU&#63; A good post-ICU convalescence period&#63; The healthcare system and its organization&#63;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Certain factors depend on the individual&#44; such as regular physical activity&#44; weight control&#44; the individual perception of sequelae and of health&#44; etc&#46; Other economic and social factors in turn impact health&#44; such as socioeconomic level and well-being&#44; but also the prevention of sequelae through an adequate rehabilitation program&#44; to avoid the impact of the techniques and treatments applied in the ICU&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The pandemic was characterized by stressed resources&#44; great teamwork&#44; and multidisciplinary efforts&#44; all with a common purpose&#46; It represented the example of a &#8220;great functional unit&#8221; in which all the professionals jointly contributed to managing the critical patient&#44; based on their own individual area of knowledge&#44; thereby affording added value&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The article combines efforts in relation to multidisciplinary work&#44; of benefit according to other studies&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> in order to address the impact of the ICU upon the functions of people&#46; Of note in the study is the evaluation of the problem of post-ICU sequelae in a multidisciplinary and proactive manner after admission&#44; with proactive follow-up of the patients&#44; from which a positive impact upon functionality can be expected&#44; in addition to an improved patient return to daily life&#44; and with the fewest sequelae possible&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Another significant point of the study is the multidimensional nature of the rehabilitation program&#44; addressing physical&#44; psychological and cognitive factors&#44; and assessing the individual in a holistic and comprehensive &#40;not only partial&#41; manner&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The study appears to record no differences in the observed sequelae according to the respiratory therapy used &#40;high-flow nasal oxygen therapy versus invasive mechanical ventilation&#41;&#46; <span class="elsevierStyleItalic">A priori</span>&#44; this finding was not to be expected&#44; since patients subjected to invasive mechanical ventilation are more seriously ill and usually suffer greater sequelae&#46; The data in this regard therefore must be viewed with caution&#46; During admission&#44; it is unclear whether early rehabilitation took place &#8211; such early measures have been shown to lessen the subsequent rehabilitation needs&#46; It is also possible that since patients requiring invasive mechanical ventilation have been more seriously ill&#44; their perception of sequelae is comparatively less intense &#8211; as has been reported in other studies on the perceived quality of life at discharge&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">From the results of the study&#44; it is seen that the patients on mechanical ventilation required more group therapy and had more functional sequelae&#46; Although significance was not reached&#44; these tendencies point to the need for further studies involving larger samples&#44; in order to consolidate the results&#46; In addition&#44; the study must be placed in the context of the pandemic&#44; in which some patients were treated outside the ICU&#44; likewise with high-flow nasal oxygen&#44; and it would be interesting to know the sequelae in this group of subjects&#44; in order to examine possible differences versus the patients admitted to the ICU&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Finally&#44; the study again places value on rehabilitation&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> multidisciplinary work and a multidimensional approach to the critical patient&#44; and concludes that there are no differences in sequelae between patients subjected to high-flow nasal oxygen therapy versus invasive mechanical ventilation&#46; Due caution is nevertheless required in interpreting these findings&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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Article information
ISSN: 21735727
Original language: English
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Medicina Intensiva (English Edition)
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?