Early mobilization practice in a single Brazilian intensive care unit

Pires-Neto, Ruy Camargo; Lima, Nilton César; Cardim, Gregorio Marques; Park, Marcelo; Denehy, Linda

doi:10.1016/j.jcrc.2015.05.004

Cited by 23 publications

(24 citation statements)

References 20 publications

(32 reference statements)

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“…Growing number of studies reporting EM therapy for patients who are receiving MV indicate obvious benefits, whereas the clinical application is still restricted. [34][35][36][37] The current state of application may be associated with a couple of main reasons. First, the acknowledged barrier to mobilize patients with MV was deep sedation, to a large extent early ICU sedation practice affects clinical outcomes, 38 so daily interruption or absence of sedatives predicts an increased probability of ambulation.…”

Section: Discussionmentioning

confidence: 99%

Early mobilization for mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis

Yue

Lei

et al. 2018

Frontiers of Nursing

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Background: Early mobilization (EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation (MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients. Methods: A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality. Secondary outcomes were adverse effects and length of stay (LOS) in intensive care unit (ICU) and hospital. Results: Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU. Conclusions: This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.

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Section: Discussionmentioning

confidence: 99%

Early mobilization for mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis

Yue

Lei

et al. 2018

Frontiers of Nursing

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“…Estadísticamente menos del 10% de los pacientes son incluidos en programas de movilización durante su estancia en cuidados intensivos [6][7][8] , a pesar de la baja ocurrencia de efectos adversos de esta intervención (menos del 1%) 6,7,9 . Generalmente el paciente es visto como demasiado enfermo para tolerar la actividad física, razón por la cual la cantidad y la calidad de los programas de rehabilitación son inadecuadas y en el 85% de los casos la rehabilitación se inicia después del egreso del paciente de la UCI 10 .…”

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Movilización segura del paciente en estado crítico: una perspectiva desde la fisiatría

Juliao¹,

Anaya²,

Avendaño³

et al. 2015

Rev Col Med Fis Reh

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RESUMENLa movilización temprana ha sido reconocida como un componente fundamental en la prevención primaria, secundaria, y terciaria por su impacto sobre la morbimortalidad global. Sin embargo, los datos de movilización temprana en unidades de cuidados intensivos (UCI) son limitados en cuanto al inicio de la intervención, el tipo de movilidad y el tiempo adecuado de realización. A su vez, existe desconfianza ante los efectos secundarios que puede generar la intervención terapéutica sobre el paciente y aunque existen publicaciones previas en las cuales se describen programas de movilidad temprana, en muchos casos estos pueden no ser generalizables. El objetivo principal de esta revisión narrativa es dar a conocer al personal de salud los parámetros que se deben tener en cuenta para realizar la movilización temprana y segura del paciente en estado crítico.

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“…O presente estudo mostra como foi a terapia de mobilidade nos pacientes queimados internados em uma Unidade de Terapia Intensiva especializada, dentro do período de um ano. (1,7,19,65) . Considerando pacientes com queimaduras na UTI, há uma escassez de dados sobre a segurança e a viabilidade da terapia de mobilidade nesta população única.…”

Section: Discussionunclassified

“…Com o avanço científico e tecnológico da medicina em terapia intensiva, a sobrevida dos pacientes críticos aumentou, e alterações fisiológicas e psicológicas, que passaram a ser observadas e descritas, tornaram-se o foco da equipe multidisciplinar que presta assistência a esses pacientes. Todo o processo terapêutico, incluindo medicações, tempo de internação e de ventilação mecânica (VM) (1,2) , além da cultura da necessidade de repouso absoluto (3)(4)(5)(6)(7)(8) , podem levar à alterações importantes de diversos sistemas orgânicos, contribuindo para o aumento do tempo de internação, aumento da morbidade, diminuição da qualidade de vida e funcionalidade dos pacientes críticos (9) . Além disso, a estada prolongada de internação hospitalar eleva os gastos com o tratamento do paciente, ocupação de leitos e risco de infecção (10) .…”

Section: Mobilização No Paciente Críticounclassified

“…As barreiras foram descritas em 470 sessões ( Tabela 3) Na alta hospitalar, a distância média de caminhada foi de 270 (136) metros, 62% do valor previsto para a idade e sexo (64) . A força de preensão manual foi de 26,5 (12,4) [9] vs 55 [7]; p = 0,368). Também encontramos uma relação positiva entre a distância percorrida noTC6M e a força de preensão manual (r = 0,555; p = 0,04) e uma correlação negativa entre o tempo de internação e a força de preensão manual (r = -0,444; p = 0,03).…”

Section: Barreirasunclassified

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Caracterização da unidade de terapia intensiva dos queimados do Hospital das Clínicas de São Paulo sob a perspectiva fisioterapêutica

Figueiredo¹

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Purpose: Patients with burn usually require prolonged hospitalization due partially to the treatment of wounds and scars. Although the benefits of early mobilization are well-known in critical care patients, there are a lack of studies reporting mobilization practices and functional status for patients with burn. Materials: Clinical and physiotherapy data were daily collected, including ICU mobility scale (IMS) and reported barriers to mobilization therapy during a oneyear period. At hospital discharge, the 6-minute walking test (6MWT), Medical Research Council scale (MRCS) and handgrip strength test were applied to evaluate the patients' functionality. Results: Of the 74 patients admitted, 66% were placed on mechanical ventilation (MV). Mobilization therapy was administered in 67.2% of physiotherapy sessions, with passive mobilization being the most prevalent (53.2%) followed by active in-bed exercises (13.6%). Reported barriers for mobilization included hemodynamic instability followed by limited time for assistance. At hospital discharge, the 6MWD was 270(136) meters. A positive correlation was found between handgrip evaluation and 6MWD and a negative correlation with hospital length of stay. Conclusions: Mobilization therapy of patients with burns in the ICU was characterized by a low mobility level during MV with a low functional status at hospital discharge.

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Early mobilization practice in a single Brazilian intensive care unit

Cited by 23 publications

References 20 publications

Early mobilization for mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis

Early mobilization for mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis

Movilización segura del paciente en estado crítico: una perspectiva desde la fisiatría

Caracterização da unidade de terapia intensiva dos queimados do Hospital das Clínicas de São Paulo sob a perspectiva fisioterapêutica

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