avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2021-11-1-22-33avk-1117Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLEРеспираторная реабилитация пост-COVID-19 пациентовRespiratory Rehabilitation for Post-Covid-19 Patientshttps://orcid.org/0000-0002-6128-5914МалявинА. Г.MalyavinA. G.

Москва

Moscow

https://orcid.org/0000-0002-6571-1220БабакС. Л.BabakS. L.

Сергей Львович Бабак, Scopus Author ID: 45560913500

Москва

Sergei L. Babak, Scopus Author ID: 45560913500

Moscow

sergbabak@mail.ruhttps://orcid.org/0000-0002-2039-0072ГорбуноваМ. В.GorbunovaM. V.

Москва

Moscow

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова», Минздрава РоссииРоссияMoscow State University of Medicine and Dentistr y named after A.I. EvdokimovRussian Federation2021260120211112233Copyright © Малявин А.Г., Бабак С.Л., Горбунова М.В., 20212021Малявин А.Г., Бабак С.Л., Горбунова М.В.Malyavin A.G., Babak S.L., Gorbunova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1117

В представленном клиническом обзоре нами оценены возможности лекарственных и немедикаментозных стратегий устранения и предотвращения патофизиологических изменений респираторной системы пост-COVID-19 пациентов. Предлагаются актуальные реабилитационные алгоритмы, основанные на оценке тяжести клинических проявлений новой коронавирусной инфекции (COVID-19), возможностях реабилитационных методик и персональной приверженности пациента к их выполнению.

In the presented clinical review, we evaluated the possibilities of drug and non-drug strategies for eliminating and preventing pathophysiological changes in the respiratory system of post-COVID-19 patients. We offer up-to-date rehabilitation algorithms based on the assessment of the severity of clinical manifestations of COVID-19, the possibilities of rehabilitation techniques and the patient’s personal compliance with their implementation.

дыхательная гимнастикаэкспираторные дыхательные тренажёрымотивирующие вдох спирометрыинтрапульмональная перкуссионная вентиляция лёгкихоткашливателиСРАР-терапияbreathing exercisesexpiratory breathing simulatorsincentive spirometerintrapulmonary percussion ventilationcoughing devicesCPAPLTOToPEPReferencesSingh S.J., Barradell A.C., Greening N.J. et al. British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population. BMJ Open. 2020;10(12):e040213. doi: 10.1136/bmjopen-2020-040213.Singh S.J., Barradell A.C., Greening N.J. et al. British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population. BMJ Open. 2020;10(12):e040213. doi: 10.1136/bmjopen-2020-040213.Smits M., Staal J.B., van Goor H. Could Virtual Reality play a role in the rehabilitation after COVID-19 infection? BMJ Open Sport Exerc Med. 2020;6(1):e000943. doi: 10.1136/bmjsem-2020-000943.Smits M., Staal J.B., van Goor H. Could Virtual Reality play a role in the rehabilitation after COVID-19 infection? BMJ Open Sport Exerc Med. 2020;6(1):e000943. doi: 10.1136/bmjsem-2020-000943.Smondack P., Gravier F.É., Prieur G. et al. Kinésithérapie et COVID-19: de la réanimation à la réhabilitation à domicile. Synthèse des recommandations internationales [Physiotherapy and COVID-19. From intensive care unit to home care-An overview of international guidelines]. Rev Mal Respir. 2020;37(10):811-822. French. doi: 10.1016/j.rmr.2020.09.001.Smondack P., Gravier F.É., Prieur G. et al. Kinésithérapie et COVID-19: de la réanimation à la réhabilitation à domicile. Synthèse des recommandations internationales [Physiotherapy and COVID-19. From intensive care unit to home care-An overview of international guidelines]. Rev Mal Respir. 2020;37(10):811-822. French. doi: 10.1016/j.rmr.2020.09.001.Abdullahi A. Safety and Efficacy of Chest Physiotherapy in Patients With COVID-19: A Critical Review. Front Med (Lausanne). 2020;7:454. doi: 10.3389/fmed.2020.00454.Abdullahi A. Safety and Efficacy of Chest Physiotherapy in Patients With COVID-19: A Critical Review. Front Med (Lausanne). 2020;7:454. doi: 10.3389/fmed.2020.00454.Зайратьянц О.В., Малявин А.Г., Самсонова М.В. и др. Патоморфологические изменения в лёгких при COVID-19: клинические и терапевтические параллели. Терапия. 2020; 5: 35-46. doi:10.18565/therapy.2020.5.35-46.Zayratyants O.V., Malyavin A.G., Samsonova M.V. et al. Pathological changes in the lungs in COVID-19: clinical and therapeutic parallels. Therapy. 2020; 5: 35-46 doi:10.18565/therapy.2020.5.35-46. [In Russian].Малявин А.Г., Адашева Т.В., Бабак С.Л. и др. Медицинская реабилитация больных, перенесших COVID-19 инфекцию. Терапия. 2020; 26(S5): 4-48 doi: 10.18565/therapy.2020.5suppl.1-48.Malyavin A.G., Adasheva T.V., Babak S.L. and others. Medical rehabilitation of patients who have undergone COVID-19 infection. Therapy. 2020; 26(S5): 4-48 doi: 10.18565/therapy.2020.5suppl.1-48 [In Russian].Demchuk A.M., Chatburn R.L. Performance Characteristics of Positive Expiratory Pressure Devices. Respir Care. 2020:respcare.08150. doi: 10.4187/respcare.08150.Demchuk A.M., Chatburn R.L. Performance Characteristics of Positive Expiratory Pressure Devices. Respir Care. 2020:respcare.08150. doi: 10.4187/respcare.08150.Малявин А.Г., Епифанов В.А., Глазкова И.И. Реабилитация при заболеваниях органов дыхания. М.: ГЭОТАР-Медиа. 2010; 352 с.Malyavin A.G., Epifanov V.A., Glazkova I.I. Rehabilitation for respiratory diseases. M.: GEOTAR-Media. 2010; 352 p. [In Russian].Shukla M, Chauhan D, Raj R. Breathing exercises and pranayamas to decrease perceived exertion during breath-holding while locked-down due to COVID-19 online randomized study. Complement Ther Clin Pract. 2020;41:101248. doi: 10.1016/j.ctcp.2020.101248.Shukla M, Chauhan D, Raj R. Breathing exercises and pranayamas to decrease perceived exertion during breath-holding while locked-down due to COVID-19 online randomized study. Complement Ther Clin Pract. 2020;41:101248. doi: 10.1016/j.ctcp.2020.101248.Мартынов А.И., Адашева Т.В., Бабак С.Л., и др. Физиотерапия и кислородотерапия пациентов с дыхательными расстройствами и нарушением мукоцилиарного клиренса. Национальные клинические рекомендации: пульмонология. Терапия. 2019; 5(приложение):101-152.Martynov A.I, Adasheva T.V., Babak S.L. et al. Physiotherapy and oxygen therapy for patients with respiratory disorders and impaired mucociliary clearance. Clinical gudelines. Therapy. 2019; 5(Suppl):101–152 [In Russian].Donadio M.V.F., Campos N.E., Vendrusculo F.M. et al. Respiratory physical therapy techniques recommended for patients with cystic fibrosis treated in specialized centers. Braz J Phys Ther. 2019:S14133555(19)30062-0. doi: 10.1016/j.bjpt.2019.11.003.Donadio M.V.F., Campos N.E., Vendrusculo F.M. et al. Respiratory physical therapy techniques recommended for patients with cystic fibrosis treated in specialized centers. Braz J Phys Ther. 2019:S14133555(19)30062-0. doi: 10.1016/j.bjpt.2019.11.003.Fink J.B. Forced expiratory technique, directed cough, and autogenic drainage. Respir Care. 2007 Sep;52(9):1210-21.Fink J.B. Forced expiratory technique, directed cough, and autogenic drainage. Respir Care. 2007 Sep;52(9):1210-21.Iannaccone S., Castellazzi P., Tettamanti A. et al. Role of Rehabilitation Department for Adult Individuals With COVID-19: The Experience of the San Raffaele Hospital of Milan. Arch Phys Med Rehabil. 2020;101(9):1656-1661. doi: 10.1016/j.apmr.2020.05.015.Iannaccone S., Castellazzi P., Tettamanti A. et al. Role of Rehabilitation Department for Adult Individuals With COVID-19: The Experience of the San Raffaele Hospital of Milan. Arch Phys Med Rehabil. 2020;101(9):1656-1661. doi: 10.1016/j.apmr.2020.05.015.Eltorai A.E.M., Baird G.L., Eltorai A.S. et al. Perspectives on Incentive Spirometry Utility and Patient Protocols. Respir Care. 2018;63(5):519-531. doi: 10.4187/respcare.05872.Eltorai A.E.M., Baird G.L., Eltorai A.S. et al. Perspectives on Incentive Spirometry Utility and Patient Protocols. Respir Care. 2018;63(5):519-531. doi: 10.4187/respcare.05872.Kotta P.A., Ali J.M. Incentive Spirometry for Prevention of Postoperative Pulmonary Complications After Thoracic Surgery. Respir Care. 2020:respcare.07972. doi: 10.4187/respcare.07972.Kotta P.A., Ali J.M. Incentive Spirometry for Prevention of Postoperative Pulmonary Complications After Thoracic Surgery. Respir Care. 2020:respcare.07972. doi: 10.4187/respcare.07972.Leemans G., Belmans D., Van Holsbeke C. et al. A Functional Respiratory Imaging Approach to the Effect of an Oscillating Positive Expiratory Pressure Device in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis. 2020 Jun 4;15:1261-1268. doi: 10.2147/COPD.S242191.Leemans G., Belmans D., Van Holsbeke C. et al. A Functional Respiratory Imaging Approach to the Effect of an Oscillating Positive Expiratory Pressure Device in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis. 2020 Jun 4;15:1261-1268. doi: 10.2147/COPD.S242191.McIlwaine M., Button B., Nevitt S.J. Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis. Cochrane Database Syst Rev. 2019;2019(11):CD003147. doi: 10.1002/14651858.CD003147.pub5.McIlwaine M., Button B., Nevitt S.J. Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis. Cochrane Database Syst Rev. 2019;2019(11):CD003147. doi: 10.1002/14651858.CD003147.pub5.Tse J., Wada K., Wang Y. et al. Impact of Oscillating Positive Expiratory Pressure Device Use on Post-Discharge Hospitalizations: A Retrospective Cohort Study Comparing Patients with COPD or Chronic Bronchitis Using the Aerobika® and Acapella® Devices. Int J Chron Obstruct Pulmon Dis. 2020; 15: 2527-2538. doi: 10.2147/COPD.S256866.Tse J., Wada K., Wang Y. et al. Impact of Oscillating Positive Expiratory Pressure Device Use on Post-Discharge Hospitalizations: A Retrospective Cohort Study Comparing Patients with COPD or Chronic Bronchitis Using the Aerobika® and Acapella® Devices. Int J Chron Obstruct Pulmon Dis. 2020; 15: 2527-2538. doi: 10.2147/COPD.S256866.Riffard G, Toussaint M. Ventilation à percussions intrapulmonaires: fonctionnement et modalités de réglage [Intrapulmonary percussion ventilation: operation and settings]. Rev Mal Respir. 2012;29(2):347-54. French. doi: 10.1016/j.rmr.2011.12.003.Riffard G, Toussaint M. Ventilation à percussions intrapulmonaires: fonctionnement et modalités de réglage [Intrapulmonary percussion ventilation: operation and settings]. Rev Mal Respir. 2012;29(2):347-54. French. doi: 10.1016/j.rmr.2011.12.003.PMID: 33085298 Murthy PR, AK A.K. High Frequency Ventilation. [Updated 2020 Sep 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020: 17p.PMID: 33085298 Murthy PR, AK A.K. High Frequency Ventilation. [Updated 2020 Sep 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020: 17p.Reychler G., Debier E., Contal O. et al. Intrapulmonary Percussive Ventilation as an Airway Clearance Technique in Subjects With Chronic Obstructive Airway Diseases. Respir Care. 2018;63(5):620-631. doi: 10.4187/respcare.05876.Reychler G., Debier E., Contal O. et al. Intrapulmonary Percussive Ventilation as an Airway Clearance Technique in Subjects With Chronic Obstructive Airway Diseases. Respir Care. 2018;63(5):620-631. doi: 10.4187/respcare.05876.Dale C.M., McKim D., Amin R. et al. Education Experiences of Adult Subjects and Caregivers for Mechanical Insufflation-Exsufflation at Home. Respir Care. 2020;65(12):1889-1896. doi: 10.4187/respcare.07534.Dale C.M., McKim D., Amin R. et al. Education Experiences of Adult Subjects and Caregivers for Mechanical Insufflation-Exsufflation at Home. Respir Care. 2020;65(12):1889-1896. doi: 10.4187/respcare.07534.Philips Respironics. Руководство пользователя Cough Assist E70. 2012: 48с. [Electronic resource]. URL: https://philipsproductcontent.blob.core.windows.net/assets/20170908/b932adc03e96f6f21f2b8512458fa06f.pdf (date of the application: 22.12.2020).Philips Respironics. Cough Assist E70 User Manual 2012: 48р. [Electronic resource]. URL: https://philipsproductcontent.blob.core.windows.net/assets/20170908/b932adc03e96f6f21f2b8512458fa06f.pdf (date of the application: 22.12.2020) [In Russian].Chatwin M., Simonds A.K. Long-Term Mechanical InsufflationExsufflation Cough Assistance in Neuromuscular Disease: Patterns of Use and Lessons for Application. Respir Care. 2020;65(2):135-143. doi: 10.4187/respcare.06882.Chatwin M., Simonds A.K. Long-Term Mechanical InsufflationExsufflation Cough Assistance in Neuromuscular Disease: Patterns of Use and Lessons for Application. Respir Care. 2020;65(2):135-143. doi: 10.4187/respcare.06882.Khor Y.H., Renzoni E.A., Visca D. et al. Oxygen therapy in COPD and interstitial lung disease: navigating the knowns and unknowns. ERJ Open Res. 2019;5(3):00118-2019. doi: 10.1183/23120541.00118-2019.Khor Y.H., Renzoni E.A., Visca D. et al. Oxygen therapy in COPD and interstitial lung disease: navigating the knowns and unknowns. ERJ Open Res. 2019;5(3):00118-2019. doi: 10.1183/23120541.00118-2019.Spruit M.A., Holland A.E., Singh S.J. et al. COVID-19: Interim Guidance on Rehabilitation in the Hospital and Post-Hospital Phase from a European Respiratory Society and American Thoracic Society-coordinated International Task Force. Eur Respir J. 2020;56(6):2002197. doi: 10.1183/13993003.02197-2020.Spruit M.A., Holland A.E., Singh S.J. et al. COVID-19: Interim Guidance on Rehabilitation in the Hospital and Post-Hospital Phase from a European Respiratory Society and American Thoracic Society-coordinated International Task Force. Eur Respir J. 2020;56(6):2002197. doi: 10.1183/13993003.02197-2020.Singh S.J., Barradell A.C., Greening N.J. et al. British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population. BMJ Open. 2020;10(12):e040213. doi: 10.1136/bmjopen-2020-040213.Singh S.J., Barradell A.C., Greening N.J. et al. British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population. BMJ Open. 2020;10(12):e040213. doi: 10.1136/bmjopen-2020-040213.Kannan S, Shaik Syed Ali Pakeer P., Sheeza Ali A. et al. Reply Letter — COVID-19 (Novel Coronavirus 2019) — Recent trends. Eur Rev Med Pharmacol Sci. 2020;24(12):6482-6483. doi: 10.26355/eurrev_202006_21629.Kannan S, Shaik Syed Ali Pakeer P., Sheeza Ali A. et al. Reply Letter — COVID-19 (Novel Coronavirus 2019) — Recent trends. Eur Rev Med Pharmacol Sci. 2020;24(12):6482-6483. doi: 10.26355/eurrev_202006_21629.van Paassen J., Vos J.S., Hoekstra E.M. et al. Corticosteroid use in COVID-19 patients: a systematic review and meta-analysis on clinical outcomes. Crit Care. 2020;24(1):696. doi: 10.1186/s13054-02003400-9.van Paassen J., Vos J.S., Hoekstra E.M. et al. Corticosteroid use in COVID-19 patients: a systematic review and meta-analysis on clinical outcomes. Crit Care. 2020;24(1):696. doi: 10.1186/s13054-02003400-9.

The authors declare that there are no conflicts of interest present.