Associação entre nível de mobilidade e o resultado da extubação em pacientes criticamente enfermos: um estudo piloto
Data
2018
Autores
Mituyama, Larissa Yukie 
Orientadores
Yamauchi, Liria Yuri
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A baixa mobilidade de pacientes internados em Unidades de Terapia Intensiva (UTI)
é consequência da fraqueza muscular adquirida em decorrência de fatores
relacionados à internação. É comum que os pacientes necessitem de ventilação
mecânica (VM) e a descontinuação desse suporte ventilatório é um processo difícil
influenciado por diversas variáveis. OBJETIVO: estimar a associação entre o nível
de mobilidade e o resultado da extubação de pacientes internados na UTI.
MÉTODOS: estudo de coorte prospectivo com início de seguimento no dia da
admissão na UTI e finalização na data da saída da UTI. Foram inclusos no estudo
pacientes ≥ 18 anos, internados na UTI Geral sob uso de VM invasiva por ≥ 24
horas. Foram coletadas variáveis demográficas e clínicas. A mobilidade foi avaliada
pela escala de mobilidade em UTI (EMU). É um instrumento simples e validado que
gradua o nível de mobilidade com um escore de 0 a 10. A EMU foi avaliada em dois
momentos: na admissão e no dia da extubação. Foi realizada a análise descritiva.
RESULTADO: foram avaliados 20 pacientes dos quais 60% do sexo masculino com
média (DP) de idade 58.5 (17) anos; a média (DP) de SAPS 3 foi de 62 (9.9) pontos;
os principais diagnósticos foram de origem gastrointestinal (50%) e respiratório
(40%); o tempo médio (DP) de intubação foi de 5 (4 - 6.5) dias; a taxa de
mortalidade na UTI foi de 25%; o sexo masculino apresentou associação com a
falência da extubação (OR = 2,33) e o aumento (variação) na escala EMU (OR =
4,30) com o sucesso da extubação. CONCLUSÃO: o aumento na mobilidade dos
pacientes internados na UTI pode estar associado ao sucesso na extubação e a
melhora do nível de mobilidade à alta da UTI
Low mobility in critically ill patients is often a consequence of ICU-acquired weakness as a result of factors related to hospitalization. It is common for patients to require mechanical ventilation (MV) and the discontinuation of this ventilator support is a difficult process influenced by several variables. OBJECTIVE: to estimate the association between the level of mobility and the successful extubation in ICU patients. METHODS: a prospective cohort study with follow-up on the day of ICU admission and finalization on the day of ICU discharge. Patients ≥ 18 years old, hospitalized in the General ICU under the use of invasive MV for ≥ 24 hours were included in the study. Demographic and clinical variables were collected. Mobility was assessed by the ICU mobility scale (IMS). A simple and validated instrument that graduates the level of mobility with a score of 0 to 10. The IMS was evaluated in two moments: on ICU admission and the day of extubation. Descriptive analysis was performed. RESULTS: 20 patients were evaluated, of which 60% were males with mean age (SD) of 58.5 (17) years; the mean (SD) of SAPS 3 was 62 (9.9) points; the main diagnoses were gastrointestinal (50%) and respiratory (40%); the mean intubation time (SD) was 5 (4 - 6.5) days; the ICU mortality rate was 25%; males were associated with extubation failure (OR = 2,33) and the increase (variation) in the IMS scale (OR = 4,30) with extubation success. CONCLUSION: the increase in the mobility of patients hospitalized in the ICU may be associated with the success in extubation and the improvement of the level of mobility to the ICU discharge
Low mobility in critically ill patients is often a consequence of ICU-acquired weakness as a result of factors related to hospitalization. It is common for patients to require mechanical ventilation (MV) and the discontinuation of this ventilator support is a difficult process influenced by several variables. OBJECTIVE: to estimate the association between the level of mobility and the successful extubation in ICU patients. METHODS: a prospective cohort study with follow-up on the day of ICU admission and finalization on the day of ICU discharge. Patients ≥ 18 years old, hospitalized in the General ICU under the use of invasive MV for ≥ 24 hours were included in the study. Demographic and clinical variables were collected. Mobility was assessed by the ICU mobility scale (IMS). A simple and validated instrument that graduates the level of mobility with a score of 0 to 10. The IMS was evaluated in two moments: on ICU admission and the day of extubation. Descriptive analysis was performed. RESULTS: 20 patients were evaluated, of which 60% were males with mean age (SD) of 58.5 (17) years; the mean (SD) of SAPS 3 was 62 (9.9) points; the main diagnoses were gastrointestinal (50%) and respiratory (40%); the mean intubation time (SD) was 5 (4 - 6.5) days; the ICU mortality rate was 25%; males were associated with extubation failure (OR = 2,33) and the increase (variation) in the IMS scale (OR = 4,30) with extubation success. CONCLUSION: the increase in the mobility of patients hospitalized in the ICU may be associated with the success in extubation and the improvement of the level of mobility to the ICU discharge
Descrição
Citação
MITUYAMA, Larissa Yukie. Associação entre nível de mobilidade e o resultado da extubação em pacientes criticamente enfermos: um estudo piloto. 2018. 32 f. Trabalho de conclusão de curso de graduação (Fisioterapia) - Instituto de Saúde e Sociedade (ISS), Universidade Federal de São Paulo (UNIFESP), Santos, 2018.