O efeito da mobilização precoce no paciente crítico: uma revisão sistemática
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Data
2022-06
Tipo de documento
Artigo Científico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
Werlang, Fernanda Gabriela Steyer da Silva
Orientador
Biasibetti, Micheli
Coorientador
Resumo
INTRODUÇÃO: A imobilidade é um problema frequente em pacientes que fazem uso da ventilação mecânica, podendo contribuir para aumentar o tempo de internação hospitalar e a chance do surgimento de fraqueza na musculatura respiratória e periférica, prejudicando suas funções e a qualidade de vida. A fraqueza adquirida é comum em pacientes internados em unidade de terapia intensiva (UTI), pacientes críticos que possuem múltiplos diagnósticos médicos, os quais geram a necessidade de intervenção fisioterapêutica. OBJETIVO: considerando as diversas alterações nos pacientes críticos e os benefícios da mobilização precoce, o objetivo do presente estudo foi avaliar o efeito da mobilização precoce no paciente crítico. MÉTODOS: foi realizada uma revisão sistemática da literatura existente nas bases de dados eletrônicas, incluindo pesquisas publicadas nos últimos 5 anos que incluíssem pacientes adultos com idade superior a 18 anos que fossem pacientes críticos, possuíssem parestesia adquirida em UTI e que empregassem os efeitos da mobilização precoce como ferramenta na reabilitação do paciente crítico. Foram incluídos apenas ensaios clínicos e randomizados. A escala Downs & Black foi aplicada nos artigos para avaliação metodológica e risco de viés. RESULTADOS: Foram selecionados 25 artigos incialmente, destes, 16 foram removidos após leitura dos resumos pois não contemplavam os critérios de elegibilidade. Restaram 9 artigos para serem avaliados, após verificação do período de publicação 5 foram removidos, restando 4 artigos com delineamentos baseado em ensaios clínicos, atendendo todos os critérios pré-estabelecidos para o desfecho pretendido. CONCLUSÃO: Após seis meses a fisioterapia apresenta-se favorável na melhora da saúde mental. Ainda sim os programas de mobilização precoce devem se fazer mais robustos e ponderados, consequentemente carecendo de mais estudos no tema abordado.
INTRODUCTION: Immobility is a frequent problem in patients who use mechanical ventilation, which can contribute to increase the length of hospital stay and the chance of weakness in the respiratory and peripheral muscles, impairing their functions and quality of life. Acquired weakness is common in patients admitted to an intensive care unit (ICU), critically ill patients who have multiple medical diagnoses, which generate the need for physical therapy intervention. OBJECTIVE: considering the various changes in critically ill patients and the benefits of early mobilization, the aim of the present study is the effect of early mobilization in critically ill patients. METHODS: a systematic review of the existing literature in electronic databases was performed, including a research published in the last 5 years that included adult patients over 18 years of age who were critically ill and had Intensive Care Unit Acquired Weaknesses (ICU-AW) and to employ the effects of early mobilization as a tool in the rehabilitation of critically ill patients. Only clinical and randomized trials were included. The Downs & Black scale was applied to articles for methodological assessment and risk of bias. RESULTS: There were 25 articles initially, of which 16 were removed after reading the abstracts because the eligibility criteria were not met. Nine articles were submitted to be evaluated, after verifying the publication period, 5 were removed, leaving 4 articles with designs based on clinical trials, meeting all the pre-established criteria for the judgment-determination. CONCLUSION: Based on the reviewed studies, it is concluded that early mobilization is essential for the functionality and improvement of critically ill patients in the ICU, presenting benefits in the long-term quality of life after hospital discharge.
INTRODUCTION: Immobility is a frequent problem in patients who use mechanical ventilation, which can contribute to increase the length of hospital stay and the chance of weakness in the respiratory and peripheral muscles, impairing their functions and quality of life. Acquired weakness is common in patients admitted to an intensive care unit (ICU), critically ill patients who have multiple medical diagnoses, which generate the need for physical therapy intervention. OBJECTIVE: considering the various changes in critically ill patients and the benefits of early mobilization, the aim of the present study is the effect of early mobilization in critically ill patients. METHODS: a systematic review of the existing literature in electronic databases was performed, including a research published in the last 5 years that included adult patients over 18 years of age who were critically ill and had Intensive Care Unit Acquired Weaknesses (ICU-AW) and to employ the effects of early mobilization as a tool in the rehabilitation of critically ill patients. Only clinical and randomized trials were included. The Downs & Black scale was applied to articles for methodological assessment and risk of bias. RESULTS: There were 25 articles initially, of which 16 were removed after reading the abstracts because the eligibility criteria were not met. Nine articles were submitted to be evaluated, after verifying the publication period, 5 were removed, leaving 4 articles with designs based on clinical trials, meeting all the pre-established criteria for the judgment-determination. CONCLUSION: Based on the reviewed studies, it is concluded that early mobilization is essential for the functionality and improvement of critically ill patients in the ICU, presenting benefits in the long-term quality of life after hospital discharge.
Palavras-chave
exercícios, mobilização precoce, UTI, paciente crítico, reabilitação