Impacto da deambulação associada à mobilização precoce em pacientes críticos: revisão sistemática

Fonseca, Diego Pereira; Filho, Vasco Junqueira Morgado; Fréz, Andersom Ricardo; Ruaro, João Afonso; Baroni, Marina Pegoraro; Daniel, Christiane Riedi

doi:10.5585/conssaude.v15n2.6043

Cited by 5 publications

(5 citation statements)

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“…Estas alterações, são responsáveis por um declínio de aproximadamente 40% da força muscular na primeira semana de imobilização em UTI, favorecendo o surgimento da fraqueza muscular adquirida na UTI. Essas informações, podem justificar o fato da brusca queda da funcionalidade motora do paciente, e a não total recuperação na alta (Oliveira et al, 2010;Fonseca et al, 2016;Silva & Pacheco, 2017;Sousa, 2017;Robinson et al, 2018).…”

Section: Resultsunclassified

Perfil funcional do paciente pós alta da Unidade de Terapia Intensiva

Carvalho

Santos

Alves

et al. 2022

RSD

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Introdução: Mesmo frente ao grande número de pacientes que tem uma sobrevida pós alta da Unidade de Terapia Intensiva (UTI), a maioria sobre complicações que afetam sua funcionalidade. Objetivo: Avaliar o perfil funcional do paciente pós alta da unidade de terapia intensiva e identificar os fatores determinantes que influenciam na funcionalidade. Metodologia: Estudo longitudinal, observacional e descritivo, tendo uma abordagem quantitativa incluindo pacientes admitidos na UTI de um Hospital Universitário no Estado de Sergipe, no período de agosto de 2018 a março de 2020. Como instrumento de pesquisa, foi usada a Medida de Independência Funcional (MIF) em três momentos: na admissão hospitalar, para mensuração da independência funcional prévia à internação hospitalar, na admissão na UTI, para mensuração da funcionalidade prévia à internação na UTI; e na alta imediata . Resultados: A amostra foi composta por 206 pacientes, sendo incluídos 91 participantes. Observou-se uma redução da MIF na admissão na UTI comparada à MIF prévia hospitalar e uma tendência à elevação na alta, porém os valores não retornam ao que foi observado antes da internação hospitalar. Além disso, aqueles pacientes com idade mais avançada e que utilizaram ventilação mecânica por um maior período e com um maior tempo de internação, foram determinantes para a MIF após a alta da UTI. Conclusão: Conclui-se que o processo de hospitalização, especialmente na UTI, de pacientes de idade mais avançada, em uso ventilação mecânica e com um maior tempo de internação, provoca uma redução significativa na funcionalidade.

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Section: Resultsunclassified

Perfil funcional do paciente pós alta da Unidade de Terapia Intensiva

Carvalho

Santos

Alves

et al. 2022

RSD

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“…Another fact that impacts the length of hospital stay, and consequently, hospital outcomes is immobility. 7,28 Therefore, defining and managing mobility goals is essential for monitoring results and their impacts on hospital outcomes. In this study, greater achievement of postoperative mobility goals was observed after the protocol, with an emphasis on early mobilization (p=0.001), elevation of the head of the bed to 60° on the 1 st PO day (p<0.005), and transfer/walking training on the 3 rd PO day (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Patients Undergoing Correction of Neuromuscular Scoliosis With a Controlled Hospital Protocol – Preliminar Outcomes

et al. 2021

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Objectives: To identify the main hospital outcomes of patients undergoing surgical correction of neuromuscular scoliosis and to assess complication rates and achievement of mobility goals after the use of a managed protocol. Methods: This is a longitudinal, retrospective study, with data obtained six months after the application of a protocol in 103 patients of both sexes submitted to surgical correction of neuromuscular scoliosis, at a tertiary level hospital in São Paulo, between June and December 2018 (pre-protocol) and between May and September 2019 (post-protocol). Data from patients who had previously undergone other orthopedic spine surgeries were excluded. In addition to the data for epidemiological characterization of the underlying diseases, the clinical characteristics and complications were analyzed. Results: Of the 103 patients evaluated, there was a predominance of females (53.4%) and a mean age of 14.9 years. The most frequent diagnosis was cerebral palsy, the mean angle of curvature was 75°, and the most frequently observed comorbidities were lung diseases (25%). The protocol was partially adhered to by professionals and after its implementation, there was a significant decrease in pain and the systemic inflammatory response syndrome (SIRS), prevention of immobility and a low rate of infection. Conclusions: The use of a protocol focused on patients undergoing correction of neuromuscular scoliosis led to reduced complications of SIRS and reduced pain; kept the surgical site infection rate low, and prevented short-term immobility. Level of evidence III; Retrospective study.

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“…13,18 Immobility, although with a small overall percentage (2%) in this study, was reported as a complication because it is a factor that can impact hospital outcomes. 19,20 The 1 st postoperative was the day of least adherence to the proposed mobility goals (24%) and this should be a point of attention to be managed in the institutions, in conjunction with patient education and the active participation of the patient and family in postoperative planning, including information about daily goals.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Profile and Outcomes in Postoperative Neuromuscular Escoliosis

Rosa¹,

Mendoza²,

Pontin³

2020

Coluna/Columna

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Objective To outline the epidemiological profile and identify the hospital outcomes of patients submitted to neuromuscular scoliosis correction surgery. Methods This was a descriptive study that included 50 patients hospitalized following surgery for neuromuscular scoliosis in a tertiary-level hospital in São Paulo from January 2017 to July 2017. The variables were collected retrospectively from the patients’ medical records: age, sex, main diagnosis, length of hospital stay, duration of surgery, hospital complications, and mobility. Results Surgeries were performed in boys and girls in similar proportions, adolescents, many with cerebral palsy (42%), with mean hospital stay of 10.8 days. Fifty-two percent presented some complication, such as constipation. Infection of the surgical site was present in 12% of the sample. Forty-two percent had moderate to intense pain and only 2% did not achieve the proposed mobility goals. Conclusion We observed that the epidemiological profile presented data consistent with the scarce literature available, while the definitions of complications, incidence, and hospital outcomes available in the literature were varied quite a bit from the findings in this study. Level of evidence III; Retrospective study.

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Impacto da deambulação associada à mobilização precoce em pacientes críticos: revisão sistemática

Cited by 5 publications

References 0 publications

Perfil funcional do paciente pós alta da Unidade de Terapia Intensiva

Perfil funcional do paciente pós alta da Unidade de Terapia Intensiva

Clinical Outcomes of Patients Undergoing Correction of Neuromuscular Scoliosis With a Controlled Hospital Protocol – Preliminar Outcomes

Epidemiological Profile and Outcomes in Postoperative Neuromuscular Escoliosis

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