An Italian consensus on pulmonary rehabilitation in COVID-19 patients recovering from acute respiratory failure: results of a Delphi process

https://doi.org/10.4081/monaldi.2020.1444

Authors

  • Michele Vitacca | michele.vitacca@icsmaugeri.it Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy. http://orcid.org/0000-0002-9389-7915
  • Marta Lazzeri Department of Cardiothoracic and Vascular Surgery; Italian Association of Respiratory Physiotherapists (ARIR) Unità Spinale, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. https://orcid.org/0000-0002-4654-6362
  • Enrico Guffanti Pneumologia Riabilitativa INRCA Casatenovo-IRCCS, Italy. https://orcid.org/0000-0002-0624-4941
  • Pamela Frigerio Maternal and Pediatric Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. https://orcid.org/0000-0003-4436-0553
  • Francesco D’Abrosca Italian Association of Respiratory Physiotherapists (ARIR), Unità Spinale ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. https://orcid.org/0000-0003-0505-2371
  • Silvia Gianola Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
  • Mauro Carone Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Institute of Bari, Italy. https://orcid.org/0000-0002-5478-8521
  • Mara Paneroni Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy. https://orcid.org/0000-0003-3982-2098
  • Piero Ceriana Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Pavia, Italy. https://orcid.org/0000-0002-4186-4257
  • Franco Pasqua Pulmonary Rehabilitation Unit, Clinical Rehabilitation Institute of Villa delle Querce, Nemi (RM), Italy. https://orcid.org/0000-0001-7992-7789
  • Paolo Banfi Pulmonary Rehabilitation Unit, Fondazione Don Carlo Gnocchi, Milan, Italy. https://orcid.org/0000-0001-8162-0751
  • Francesco Gigliotti Pulmonary Rehabilitation Unit, Fondazione Don Carlo Gnocchi, Florence, Italy. https://orcid.org/0000-0003-4608-2059
  • Carla Simonelli Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy. https://orcid.org/0000-0003-2238-7499
  • Serena Cirio Pulmonary Rehabilitation Units, ICS Maugeri IRCCS, Pavia, Italy. https://orcid.org/0000-0002-9714-8970
  • Veronica Rossi Health Professions Department Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy. https://orcid.org/0000-0002-7114-7937
  • Chiara G. Beccaluva Pulmonary Rehabilitation Unit, ASST Ospedale Maggiore, Crema, Italy.
  • Mariangela Retucci Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy. https://orcid.org/0000-0003-2952-4847
  • Martina Santambrogio Italian Association of Respiratory Physiotherapists (ARIR), Unità Spinale, Grande Ospedale Metropolitano Niguarda, Milan, Italy. https://orcid.org/0000-0002-7428-7927
  • Andrea Lanza Italian Association of Respiratory Physiotherapists (ARIR), Unità Spinale; Department of Neuroscience, Sleep Medicine Center ,Grande Ospedale Metropolitano Niguarda, Milan, Italy. https://orcid.org/0000-0001-5859-2238
  • Francesca Gallo Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Alessia Fumagalli Pulmonary Rehabilitation Unit, Italian National Research on Aging (IRCCS INRCA), Casatenovo (LC), Italy. https://orcid.org/0000-0003-1367-8374
  • Marco Mantero Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy. https://orcid.org/0000-0001-7324-1217
  • Greta Castellini Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. https://orcid.org/0000-0002-3345-8187
  • Mariaconsiglia Calabrese AOU San Giovanni di Dio e Ruggi d’Aragona, University of Salerno, Italy.
  • Giorgio Castellana Pulmonary Rehabilitation Units, ICS Maugeri IRCCS, Pavia, Italy.
  • Eleonora Volpato Pulmonary Rehabilitation Unit, Fondazione Don Carlo Gnocchi, Milan, Italy.
  • Marina Ciriello Società Italiana Fisioterapia e Riabilitazione (S.I.Fi.R.), Italy.
  • Marina Garofano Società Italiana Fisioterapia e Riabilitazione (S.I.Fi.R.), Italy. https://orcid.org/0000-0003-1600-4682
  • Enrico Clini Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy. https://orcid.org/0000-0002-1515-5094
  • Nicolino Ambrosino Pulmonary Rehabilitation Unit, ICS Maugeri IRCCS, Pavia;, Italy. https://orcid.org/0000-0002-5331-1393
  • on behalf of AIPO, ARIR, SIP, AIFI and SIFIR

Abstract

There is a need of consensus about the pulmonary rehabilitation (PR) in patients with COVID-19 after discharge from acute care. To facilitate the knowledge of the evidence and its translation into practice, we developed suggestions based on experts’ opinion. A steering committee identified areas and questions sent to experts. Other international experts participated to a RAND Delphi method in reaching consensus and proposing further suggestions. Strong agreement in suggestions was defined when the mean agreement was >7 (1 = no agreement and 9 = maximal agreement). Panelists response rate was >95%. Twenty-three questions from 4 areas: Personnel protection equipment, phenotypes, assessments, interventions, were identified and experts answered with 121 suggestions, 119 of which received high level of concordance. The evidence-based suggestions provide the clinicians with current evidence and clinical experts opinion. This framework can be used to facilitate clinical decision making within the context of the individual patient. Further studies will evaluate the clinical usefulness of these suggestions.

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Published
2020-06-23
Info
Issue
Section
COVID-19 - Collection of articles on the Coronavirus outbreak
Keywords:
COVID-19, SARS-CoV-2, physiotherapy, exercise, dyspnea, pandemics, Delphi process
Statistics
  • Abstract views: 7597

  • PDF: 4344
  • Appendix: 261
How to Cite
Vitacca, Michele, Marta Lazzeri, Enrico Guffanti, Pamela Frigerio, Francesco D’Abrosca, Silvia Gianola, Mauro Carone, Mara Paneroni, Piero Ceriana, Franco Pasqua, Paolo Banfi, Francesco Gigliotti, Carla Simonelli, Serena Cirio, Veronica Rossi, Chiara G. Beccaluva, Mariangela Retucci, Martina Santambrogio, Andrea Lanza, Francesca Gallo, Alessia Fumagalli, Marco Mantero, Greta Castellini, Mariaconsiglia Calabrese, Giorgio Castellana, Eleonora Volpato, Marina Ciriello, Marina Garofano, Enrico Clini, Nicolino Ambrosino, and on behalf of AIPO, ARIR, SIP, AIFI and SIFIR. 2020. “An Italian Consensus on Pulmonary Rehabilitation in COVID-19 Patients Recovering from Acute Respiratory Failure: Results of a Delphi Process”. Monaldi Archives for Chest Disease 90 (2). https://doi.org/10.4081/monaldi.2020.1444.

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