Efectos de la rehabilitación temprana en el paciente adulto en condición crítica: una revisión narrativa

Javier López-Yarce; Obed Solis Martínez; Ruben Antonio Vázquez-Roque

doi:10.35454/rncm.v6n2.505

Autores/as

Javier López-Yarce Universidad Popular Autónoma del Estado de Puebla
Obed Solis Martínez Universidad Popular Autónoma del Estado de Puebla
Ruben Antonio Vázquez-Roque Benemérita Universidad Autónoma de Puebla https://orcid.org/0000-0002-2712-5714

DOI:

https://doi.org/10.35454/rncm.v6n2.505

Palabras clave:

cuidado crítico, fisioterapia, enfermedad critica, rehabilitación temprana, unidad de cuidados intensivos, desgaste muscular, debilidad muscular, ejercicio

Resumen

La inactividad física del paciente durante una larga estadía hospitalaria contribuye a la pérdida de masa muscular, principalmente en las extremidades inferiores, lo que a su vez genera complicaciones y estancias hospitalarias prolongadas. El estado catabólico durante la enfermedad crítica provoca un cambio de rol en el músculo. Por día, en la unidad de cuidados intensivos (UCI) hay una pérdida del 2 % de masa muscular, y durante la primera semana de estancia hospitalaria hay una pérdida del 12,5 % del área transversal muscular en presencia de ventilación mecánica (VM). La debilidad adquirida en la UCI (DAUCI) es una condición de debilidad generalizada que se presenta durante la enfermedad crítica y que ocurre hasta en un 50 % de los pacientes críticamente enfermos. La DAUCI se relaciona principalmente con inmovilización en la cama hospitalaria, mayor duración de la VM, aumento de la estancia hospitalaria acompañada de una reducción de masa muscular esquelética, así como aumento de la mortalidad. En la UCI, el principal indicador a evaluar en el paciente es la debilidad muscular. El objetivo de esta revisión es describir los efectos de la estancia prolongada y el reposo en cama sobre el paciente en condición crítica, así como la importancia de la rehabilitación temprana. De acuerdo con los resultados, la rehabilitación temprana basada en la movilidad progresiva en la UCI es un tema prioritario que tiene la finalidad de prevenir el deterioro musculoesquelético y favorecer la recuperación física; además, reduce la estancia en la UCI, disminuye los días de VM, mejora la calidad de vida y disminuye la mortalidad.

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