Dique Filipeia: A rehabilitation protocol for non-intubated COVID-19 in-hospital patients

Frazao, M.; Paiva, K. M.; S, R. M. d. N.; Menezes, F. d. S.; Alves, L. A. d. S.; Souza Rocha, A. I. S. d.; Franca, E. E. T.; Santos, A. d. C.; Brasileiro-Santos, M. d. S.

Objective: The aim of this study was to evaluate the effectiveness of the Dique Filipeia rehabilitation protocol in patients with COVID-19 admitted to reference hospitals. Methods: This is an experimental study with COVID-19 patients admitted to the hospitals wards being considered eligible. The study outcomes were assessed between patients undergoing the rehabilitation protocol (Dique Filipeia group) and patients who did not receive the protocol (control group). The rehabilitation protocol consisted in classifying patients daily into four levels of severity through peripheral oxygen saturation. Severity was classified by the oxygen flow needed to maintain a saturation greater than or equal to the cut-off point of 93%. A standardized ventilatory support and functional rehabilitation exercises were performed for each severity level patient, followed by an attempt to wean oxygen. Results: A total of 727 patients were analyzed in the study. The Dique Filipeia group presented a lower total (132.7 vs 307.0 m3/patient; effect size 1.73) and daily (2.9 vs 6.8 m3/day/patient; effect size 1.46) oxygen expenditure than the control group. The Dique Filipeia patients presented higher hospital discharge (64.9 vs 35.4%; effect size 3.46) and lower length of stay (15.8 vs 29.1 days; effect size 3.47) than the control group. The Dique Filipeia group patients, who were demanding oxygen therapy, were using 6.2 L/min of oxygen at day 1. There was a statistically significant reduction from day 2 (p = 0.0001) and oxygen flow was reduced below 1L/min after day 7. Conclusions: The implementation of a standardized rehabilitation protocol reduced oxygen expenditure, increased hospital discharge and reduced the length of hospital stay. Dique Filipeia is a practical, feasible and safe protocol.