Rehabilitación precoz del enfermo crítico con debilidad muscular adquirida en la UCI: Un estudio cuasiexperimental
DOI:
https://doi.org/10.12707/RVI22057Palabras clave:
cuidados críticos, resultados de cuidados críticos, enfermería en rehabilitación, debilidad muscularResumen
Marco contextual: La debilidad muscular adquirida en cuidados intensivos es una complicación importante y la rehabilitación precoz puede mejorar el pronóstico del enfermo crítico.
Objetivo: Analizar los resultados en pacientes críticos diagnosticados de debilidad muscular adquirida en cuidados intensivos, sensibles a la intervención de enfermería de rehabilitación.
Metodología: Estudio cuasiexperimental, con una muestra no probabilística compuesta por 80 personas, divididas en grupo experimental y grupo de control. Los grupos recibieron el mismo estándar de cuidados de enfermería de rehabilitación, diferenciados en cantidad y frecuencia según el intervalo de tiempo.
Resultados: Los participantes del grupo experimental tuvieron mayor independencia funcional en la transferencia, mayor fuerza muscular al ser dados de alta, reducción del número medio de días de sedación, de ventilación mecánica invasiva, de estancia hospitalaria y de la puntuación del Therapeutic Intervention Scoring System 28 en el momento del alta.
Conclusión: El aumento de la cantidad y la frecuencia de la intervención de enfermería de rehabilitación permitió una mejora de los resultados en la persona en estado crítico.
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Cullen, D. J., Civetta, J. M., Briggs, B. A., & Ferrara, L. C. (1974). Therapeutic intervention scoring system: A method for quantitative comparison of patient care. Critical Care Medicine, 2(2), 57–60. https://pubmed.ncbi.nlm.nih.gov/4832281/
Data Management Service of the Uniform Data System for Medical Rehabilitation and the Center for Functional Assessment Research. (1986). Australian guide for use of the uniform data set for medical rehabilitation including the functional independence measure: Version 3.1. State University of New York at Buffalo.
Eggmann, S., Verra, M. L., Luder, G., Takala, J., & Jakob, S. M. (2016). Effects of early, combined endurance and resistance training in mechanically ventilated, critically ill patients: A study protocol for a randomised controlled trial. Trials, 17(403), 1–11. https://doi.org/10.1186/s13063-016-1533-8
Eggmann, S., Verra, M. L., Luder, G., Takala, J., & Jakob, S. M. (2018). Effects of early, combined endurance and resistance training in mechanically ventilated, critically ill patients: A randomized controlled trial. Plos One, 13(11), 1–19. https://doi.org/10.1371/journal.pone.0207428
Ely, E. W., Truman, B., Shintani, A., Thomason, J. W., Wheeler, A. P., Gordon, S., Francis, J., Speroff, T., Gautam, S., Margolin, R., Sessler, C. N., Dittus, R. S., & Bernard, G. R. (2003). Monitoring sedation status over time in ICU patients: Reliability and validity of the richmond agitation-sedation scale (RASS). Journal of the American Medical Association, 289(22), 2983–2991. https://doi.org/10.1001/jama.289.22.2983
Gruther, W., Pieber, K., Steiner, I., Hein, C., Hiesmayr, J. M., & Paternostro-Sluga, T. (2017). Can early rehabilitation on the general ward after an intensive care unit stay reduce hospital length of stay in survivors of critical illness?: A randomized controlled & trial. American Journal of Physical Medicine Rehabilitation, 96(9), 607-615. https://doi.org/10.1097/PHM.0000000000000718
Hashem, M. D., Nelliot, A., & Needham, D. M. (2016). Early mobilization and rehabilitation in the ICU: moving back to the future. Respiratory care, 61(7), 971-979. https://doi.org/10.4187/respcare.04741
Huang, D., Zhao, W., Chen, Y., Shen, B., Wang, Y., Guan, H., & Luo, W. (2021). Effect of mechanical ventilation and pulmonary rehabilitation in patients with ICU-acquired weakness: A systematic review and meta-analysis. Annals of Palliative Medicine, 10(9), 9594-9606. https://doi.org/10.21037/apm-21-1928
Lang, J. K., Paykel, M. S., Haines, K. J., & Hodgson, C. L. (2020). Clinical practice guidelines for early mobilization in the ICU: A systematic review. Critical Care Medicine 48(11), e1121–e1128. https://doi.org/10.1097/CCM.0000000000004574
Gall, J. R., Loirat, P., Alperovitch, A., Glaser, P., Granthil, C., Mathieu, D., Mercier, P., Thomas, R., & Villers, D. (1984). A simplified acute physiology score for ICU patients. Critical Care Medicine, 12(11), 975-977. https://doi.org/10.1097/00003246-198411000-00012
Medical Research Council. (1943). Aids to the examination of the peripheral nervous system. Her Majesty’s Stationery Office.
Moreno, R., & Morais, P. (1997). Outcome prediction in intensive care: results of a prospective, multicentre, Portuguese study. Intensive Care Medicine, 23, 177–186. https://doi.org/10.1007/s001340050313
National Institute for Health and Care Excellence. (2020). Supporting adult carers. https://www.nice.org.uk/guidance/ng150/resources/supporting-adult-carers-pdf-66141833564869
Nassar Junior, A. P., Pires Neto, R. C., Figueiredo, W. B., & Park, M. (2008). Validity, reliability and applicability of Portuguese versions of sedation-agitation scales among critically ill patients. Sao Paulo Medical Journal, 126(4), 215–219.
https://www.scielo.br/j/spmj/a/mp4wKYWf6pf8TbqMbGmSH6j/?lang=en&format=pdf
Nydahl, P., Diers, A., Günther, U., Haastert, B., Hesse, S., Kerschensteiner, C., Klarmann, S., & Köpke, S. (2018). Protokollbasierte mobilisierung auf Intensivstationen: Design einer clusterran domisierten pilotstudie. Medizinische Klinik – Intensivmedizin Und Notfallmedizin, 113(7), 581–592. https://doi.org/10.1007/s00063-017-0358-x
Piva, S., Fagoni, N., & Latronico, N. (2019). Intensive care unit–acquired weakness: Unanswered questions and targets for future research. F1000Research, 8(508), 1–10. https://f1000research.s3.amazonaws.com/manuscripts/19002/81f9b867-6957-446f-9de1-88a0568d2266_17376__latronico.pdf?doi=10.12688/f1000research.17376.1&numberOfBrowsableCollections=94&numberOfBrowsableInstitutionalCollections=4&numberOfBrowsableGateways=51
Knaus, W. A., Zimmerman, J. E., Wagner, D. P., Draper, E. A., & Lawrence, D. E. (1981). APACHE-acute physiology and chronic health evaluation: A physiologically based classification system. Critical Care Medicine, 9(8), 591-597. https://doi.org/10.1097/00003246-198108000-00008
Schoeller, S. D., Martins, M. M., Ribeiro, I., Lima, D. K., Padilha, M. I., & Gomes, B. P. (2018). Breve panorama mundial da enfermagem da reabilitação. Revista Portuguesa de Enfermagem de Reabilitação, 1(1), 6–12. https://doi.org/10.33194/rper.2018.v1.n1.01.4388
Vanhorebeek, I., Latronico, N., & Van den Berghe, G. (2020). ICU-acquired weakness. Intensive Care Medicine, 46(4), 637–653. https://doi.org/10.1007/s00134-020-05944-4
Vincent, J. L., Mendonça, A., Cantraine, F., Moreno, R., Takala, J., Suter, P. M., Sprung, C. L., Colardyn, F., & Blecher, S. (1998). Use of the SOFA score to assess the incidence of organ dysfunction/ failure in intensive care units: Results of a multicenter, prospective study. Critical Care Medicine, 26(11), 1793-1800. https://doi.org/10.1097/00003246-199811000-00016
