COMPRENSION DE TEXTOS EN INGLES.

EVIDENCIA 3

CARRERA: CONTADOR PUBLICO

ALUMNA: DALIA CRISTAL CEDILLO SAUCEDO
MATRICULA: 2079778
MAESTRA: NANCY DALIA SALINAS
TURNO NOCTURNO 3 BC
Introduction
Coronavirus disease in the current context of pandemic constitutes a health problema public, especially
in elderly patients, since it is the population mostly affected both in terms of mortality and morbidity.
This is because it interferes with survivors both physically and psychosocially and generates specific
problems including severe muscle weakness and fatigue, joint stiffness, dysphagia, neuropsychological
problems, breathing problems and performance problems related to mobility, so that it produces an
important limitation on participation
Patients diagnosed with covid-19 may have a rapid progression of respiratory failure preceded by
dyspnea and hypoxemia, associated to the acute appearance of bilateral infiltrates in the
diagnostic imaging, severe hypoxemia, and edema pulmonary Patients with chronic conditions such
as obesity, diabetes mellitus, and cardiovascular diseases are more prone to severe disease.
Currently there is insufficient data of covid-19 survivors regarding presentation and rehabilitation needs.
To date, various studies are under development, but the information available at the moment is
anecdotal and derived, mainly, from people who have developed adult respiratory distress syndrome
(ARDS). Thus, the amount of time on mechanical ventilation is days in intensive care unit (ICU), and
the level of sedation required, as well as the functional level to date seven post-extubation are the main
indicators long-term recovery
Pulmonary rehabilitation
Pulmonary rehabilitation (pr) is defined according to latest update of the American Society of the Thorax
and the European Respiratory Society, as one. In Colombia, the programs of pulmonary rehabilitation
since 1996. The first results of a research study that evidenced its effects on exercise capacity and
quality of life in respiratory patients Chronic altitudes occurred in 2001, and in In 2004, the issuance of
External Circular No. 0094 of December 6 from the Ministry of Social Protection, which describes the
coverage of services for the PR, which allows the coverage of this intervention by the plans health
benefits
Pulmonary rehabilitation should be part comprehensive treatment of patients with chronic respiratory
disease. It is a measure non-pharmacological therapy recognized as the key point for the improvement
of the disease, with a level of evidence documented in respiratory diseases such as COPD or asthma.
It is also a multidisciplinary intervention, individualized and flexible that allows adapting to the individual
needs of each patient, aimed at reducing the symptoms of the disease, improve functional capacity,
optimize participation in the social and work environment, as well as in reducing health costs through
stabilization or reversal of manifestations systemic disease.
Need for a program pulmonary rehabilitation in surviving patients of covid-19
The three main components of a system health care - prevention, treatment and rehabilitation - are
equally important in treatment of any serious illness and Covid-19 infection is no exception. By so fast
introduction and availability continuous pulmonary rehabilitation services is essential for these patients,
which is why which both the Regional Office for the Americas of the World Health Organization (who)
such as the Pan American Health Organization (ops) recommend, based on the precept according to
the which rehabilitation improves the health outcomes of patients with severe Covid-19, benefits health
services by optimizing health and functioning outcomes by reducing complications associated with a
stay in ICU (such as, for example, the post-intensive care syndrome, among others), as well as it allows
to reduce the risk of readmission by helping patients not to deteriorate after the discharge, which is
essential in a context shortage of hospital beds, the implementation of pr programs that, ideally, should
be integrated into national plans for emergencies caused by covid-19
Evidence of rehabilitation pulmonary in patients with acute respiratory síndrome severe
Severe acute respiratory syndrome (severe acute respiratory syndrome or sars) is a viral respiratory
disease caused by sars-CoV-2 coronavirus, which was reported for the first time in Asia in February
2003. Few months later the disease spread more tan two dozen countries in North America, South
America, Europe and Asia before it was possible to contain the global outbreak. According to the who,
a total of 8,098 people around the world got sick during the outbreak; Of this number, 774 people died,
and it was China the most affected country
Follow-up studies showed that after hospital discharge, patients with sars presented symptoms
characterized mainly by restrictive pulmonary dysfunction, palpitations, muscle weakness in the
extremities, avascular necrosis of the head of the femur and dyspnea on exertion, all of which limited
their.
Objectives of the program pulmonary rehabilitation in surviving patients of covid-19
The global pulmonary rehabilitation program goals have been developed based on staff referrals who
has worked with these patients in the first line of disease care; mainly rehabilitation specialists in China
and, more recently, in the consensus insude by the American Thoracic Society (American Thoracic
Society-ats) and the European Respiratory Society-ers, who have developed rehabilitation guidelines
Practical and feasible lung disease for covid-19 survivors..
General objective
The general objective is to create a pulmonary rehabilitation protocol to ensure that the patient with
severe or severe covid-19 disease moderate with lung involvement and required hospital or ICU
management, with oxygen supplementation and mechanical ventilation, reach its máximum functional
and emotional capacity, which in turn facilitate the maximum degree of autonomy and improvement in
health-related quality of life.
Specific objectives
The specific objectives are listed below. Minimize dyspnea, relieve anxiety and depression associated
with the disease.

◾ Promote functional independence to the máximum through improvement in cardiopulmonary

capacity, strength and endurance.

◾ Evaluate the impact of the program through functional scales that evaluate, in turn, the physical,
cognitive and emotional component

◾ Benefits of a program pulmonary rehabilitation in surviving patients of covid-19

As previously mentioned, to date there are no prospective studies evaluating the benefits
obtained in surviving Covid-19 patients;
Indications of a program pulmonary rehabilitation in surviving patients of covid-19 Inclusion criteria
The pulmonary rehabilitation program is indicated in any patient who has presented infection by the
sars-CoV-2 virus, has developed Covid-19 disease with pulmonary involvement requiring hospital care
both in ICU as in a hospitalization floor and has presented onset of symptoms in at least twenty days
prior to entering the program
Exclusion criteria
Exclusion criteria are listed below.

◾ Have little personal motivation.

◾ Present a history of psychiatric disorder severe, cognitive disorders or mental síndrome organic that
prevent interaction or understanding instructions.

◾ Severe arrhythmias, exercise-induced syncope, or decompensated metabolic disorders or that do

not have proper management.

◾ Coexistence of musculoskeletal problems or neurological disorders that reduce mobility.

Members of the team pulmonary rehabilitation in surviving patients of covid-19
A pr program can be developed at the level hospital or outpatient, depending on the possibilities of the
institution where it is carried out out.
The multidisciplinary team of the program is composed of different health professionals, motivated,
trained and with complementary functions, focused on physical and social attention to patients, who
provide individualized care adapted to the disease, its behavior and evolution, with an emphasis on
education for self-care, in psychosocial support for social insertion and improvement of the quality of
life of the sick and their families, with evaluation and monitoring of the results obtained.
Duration and components of rehabilitation program lung for survivors from covid-19
There is currently no global consensus on the optimal duration of a rehabilitation program pulmonary.
Based on the recommendations of the ats / ers, the program will last from eight to twelve weeks, during
which twenty-four to thirty-six sessions are carried out, with a frequency of three to five sessions per
week and a minimum duration of one hour per session
The program must include, fundamentally, an initial specialized medical evaluation that includes
cardiorespiratory and functional physical examination, as well as different paraclinical tests, aerobic
training, peripheral muscle strength, respiratory training, patient education and family, psychosocial
support, nutritional support, of occupational therapy and speech therapy. It is important to apply an
individualized pulmonary rehabilitation program that must be appropriate to each patient.
The time of admission of patients to program is a matter of discussion at the moment. It is currently
suggested that patients who only required hospitalization on a hospital floor enter at least two weeks
after thehigh, while those who were admitted to ICU do so at least three weeks after having been
dehospitalized.
As a general recommendation it is important emphasize that, prior to the start of all sessions, thus as
during these and at the end, vital signs monitoring with voltage tapping should be performedblood
pressure, heart rate, and pulse oximetry.
Conclusion
Doctors who are engaged in rehabilitation as well like rehabilitation itself, can play a key role in restoring
the function and limitation of disability in this pandemic. The interventions of both groups general
rehabilitation as well as rehabilitation pulmonary provide additional tools infight against covid-19 and
can include a large number of actors in the health field, who can provide their knowledge in order to
achieve maximum recovery for these patients.
In the months or years after this pandemic the burden of disease can be great and pulmonary
rehabilitation programs will play a crucial role in the rehabilitation of patients with disability in relation to
covid-19.
Summary
Coronavirus disease 2019 (covid-19) caused by sars-CoV-2 virus is a new disease characterized by
generating lung damage and involvement of multiple tissues and organs of the whole body. Some of
the patients who present the infection warrant in-hospital management with O2 support and additional
measures that may include prolonged immobilization in ICU.
Patients who present moderate or severe symptoms and survive the disease they can present long-
term deterioration and dysfunctions, including pulmonary fibrosis, cardiomyopathy, kidney, liver and
peripheral nerve damage and all complications derived from ICU hospitalizations. Pulmonary
rehabilitation intervention is considered to be of great importance, especially in the recovery stage, and
should be carried out, mainly, with the objectives of improve dyspnea, severe muscle weakness and
fatigue, in order to promote functional independence and increase quality of life, thereby reducing
anxiety and depression.
Members of the team pulmonary rehabilitation in surviving patients of covid-19
A pr program can be developed at the level hospital or outpatient, depending on the possibilities of the
institution where it is carried out out.
The multidisciplinary team of the program is composed of different health professionals, motivated,
trained and with complementary functions, focused on physical and social attention to patients, who
provide individualized care adapted to the disease, its behavior and evolution, with an emphasis on
education for self-care, in psychosocial support for social insertion and improvement of the quality of
life of the sick and their families, with evaluation and monitoring of the results obtained.
Pulmonary rehabilitation (pr) is defined according to latest update of the American Society of the Thorax
and the European Respiratory Society, as one. In Colombia, the programs of pulmonary rehabilitation
since 1996. The first results of a research study that evidenced its effects on exercise capacity and
quality of life in respiratory patients Chronic altitudes occurred in 2001, and in In 2004, the issuance of
External Circular No. 0094 of December 6 from the Ministry of Social Protection, which describes the
coverage of services for the PR, which allows the coverage of this intervention by the plans health
benefits
Pulmonary rehabilitation should be part comprehensive treatment of patients with chronic respiratory
disease. It is a measure non-pharmacological therapy recognized as the key point for the improvement
of the disease, with a level of evidence documented in respiratory diseases such as COPD or asthma.
It is also a multidisciplinary intervention, individualized and flexible that allows adapting to the individual
needs of each patient, aimed at reducing the symptoms of the disease, improve functional capacity,
optimize participation in the social and work environment, as well as in reducing health costs through
stabilization or reversal of manifestations systemic disease.
Need for a program pulmonary rehabilitation in surviving patients of covid-19
The three main components of a system health care - prevention, treatment and rehabilitation - are
equally important in treatment of any serious illness and Covid-19 infection is no exception. By so fast
introduction and availability continuous pulmonary rehabilitation services is essential for these patients,
which is why which both the Regional Office for the Americas of the World Health Organization (who)
such as the Pan American Health Organization (ops) recommend, based on the precept according to
the which rehabilitation improves the health outcomes of patients with severe Covid-19
Evidence of rehabilitation pulmonary in patients with acute respiratory síndrome severe
Severe acute respiratory syndrome (severe acute respiratory syndrome or sars) is a viral respiratory
disease caused by sars-CoV-2 coronavirus, which was reported for the first time in Asia in February
2003. Few months later the disease spread more tan two dozen countries in North America, South
America, Europe and Asia before it was possible to contain the global outbreak. According to the who,
a total of 8,098 people around the world got sick during the outbreak; Of this number, 774 people died,
and it was China the most affected country
Objectives of the program pulmonary rehabilitation in surviving patients of covid-19
The global pulmonary rehabilitation program goals have been developed based on staff referrals who
has worked with these patients in the first line of disease care; mainly rehabilitation specialists in China
and, more recently, in the consensus insude by the American Thoracic Society (American Thoracic
Society-ats) and the European Respiratory Society-ers, who have developed rehabilitation guidelines
Practical and feasible lung disease for covid-19 survivors..
As previously mentioned, to date there are no prospective studies evaluating the benefits
obtained in surviving Covid-19 patients;
Indications of a program pulmonary rehabilitation in surviving patients of covid-19 Inclusion criteria
The pulmonary rehabilitation program is indicated in any patient who has presented infection by the
sars-CoV-2 virus, has developed Covid-19 disease with pulmonary involvement requiring hospital care
both in ICU as in a hospitalization floor and has presented onset of symptoms in at least twenty days
prior to entering the program
Duration and components of rehabilitation program lung for survivors from covid-19
There is currently no global consensus on the optimal duration of a rehabilitation program pulmonary.
Based on the recommendations of the ats / ers, the program will last from eight to twelve weeks, during
which twenty-four to thirty-six sessions are carried out, with a frequency of three to five sessions per
week and a minimum duration of one hour per session
The program must include, fundamentally, an initial specialized medical evaluation that includes
cardiorespiratory and functional physical examination, as well as different paraclinical tests, aerobic
training, peripheral muscle strength, respiratory training, patient education and family, psychosocial
support, nutritional support, of occupational therapy and speech therapy. It is important to apply an
individualized pulmonary rehabilitation program that must be appropriate to each patient
BIBLIOGRAPHY
https://www.redalyc.org/journal/910/91068348007/91068348007.pdf