Mobilização precoce no paciente crítico: quando começar?

• Autor(a) principal: PIEROLI, Pedro Henrique
• Data de Publicação: 2021
• Outros Autores: GRAVENA, Silvia Rodrigues
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Digital Unicesumar
• Texto Completo: http://rdu.unicesumar.edu.br/handle/123456789/7433
• topic: mobilização precoce; fraqueza muscular; unidade de terapia intensiva; fisioterapia; CNPQ::CIENCIAS DA SAUDE

Through a narrative review, it aimed to identify the best time to start the early mobilization program for critically ill patients. Critical ill patients, most of them are men, over 60 years old, in which their cardiovascular conditions are one of main reasons of hospitalization that, due to the seriousness of the health condition, mean length of stay in intensive care unit (ICU) is seven days. Therefor, the patients are submitted to immobilization for a prolong period and as a consequence, secondary complications arise, among them: pulmonary edema, atelectasis, bone demineralization, vasomotor instability, constipation, pressure ulcers, blood clots, but, mainly, there will be a loss of intervention and decline of muscle mass resulting in muscle weakness acquired at ICU. The early mobilization in the ICU is intended to help the patient to maintain or restore the mobility and functional independence, minimizing the muscle weakness’s effects and, in addition, it shown to be an important strategy in reducing of the hospitalization time. However, there is no definite standardization on early mobilization, mainly related to the start time, but is fact that the patient’s individuality, the protocol used, the moment of the strategy, well as several barriers that are imposed, can influence the results, however, the early mobilization has proved effective in this population when started in 48 and 72 hours, as long as the patient is hemodynamically stable. And when a careful evaluation of peripheral and respiratory muscle strength is employed to direct to the strengthening protocol, it will have a positive impact on the weaning process of mechanical ventilation more quickly, since limb weakness is related to severe respiratory muscle weakness and, consequently, longer ventilatory support time.