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

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

Palavras-chave:

Cuidado Crítico, Fisioterapia, doença crítica, reabilitação precoce, unidade de terapia intensiva, desgaste muscular, fraqueza muscular, exercício

Resumo

A inatividade física do paciente durante uma longa internação hospitalar contribui para a perda de massa muscular, principalmente nas extremidades inferiores, o que por sua vez gera complicações e internações prolongadas. O estado catabólico durante a doença crítica causa uma mudança de função no músculo. Por dia, na unidade de terapia intensiva (UTI) há perda de 2% da massa muscular, sendo que na primeira semana de internação hospitalar há perda de 12,5% da área de secção transversa do músculo na presença de ventilação mecânica (VM). A fraqueza adquirida na UTI (FMA-UTI) é uma condição de fraqueza generalizada que ocorre durante uma doença crítica e ocorre em até 50% dos pacientes gravemente enfermos. A FMA-UTI está relacionada principalmente à imobilização no leito hospitalar, maior duração da VM, aumento do tempo de internação acompanhada de redução da massa muscular esquelética, bem como aumento da mortalidade. Na UTI, o principal indicador a avaliar no paciente é a fraqueza muscular. O objetivo desta revisão foi descrever os efeitos da permanência prolongada e do repouso no leito no paciente em estado crítico, bem como a importância da reabilitação precoce. De acordo com os resultados, a reabilitação precoce baseada na mobilidade progressiva na UTI é uma questão prioritária que visa prevenir a deterioração musculoesquelética e favorecer a recuperação física, além disso, reduz a permanência na UTI, diminui os dias de VM, melhora a qualidade de vida e diminui a mortalidade.

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