Mobilização precoce de pacientes críticos como preditor de status funcional: revisão de literatura

Abstract

Patients afflicted from critical illnesses requiring mechanical ventilation (MV), continuous sedation besides the prolonged stay in the Intensive Care Unit (ICU) are associated with increased mortality, morbidity, high cost and length of hospital stay, besides the important functional decline due to complications resulting from the deleterious effects of the bed, between them, the most frequent, muscle weakness. Therefore, attention has been directed to intervene as early as possible in critically ill patients intention to minimize the dysfunctions related to rest and disuse muscle. Physiotherapy is a science that can promote recovery and preservation of functionality of these individuals. The objective of this literature review is to describe kind of exercises used early in intensive care and its impact on the functionality of critical patients. Were performed a literature search in Medline / PubMed, SciELO, LILACS, PEDro, Bireme and Google Scholar from 2005. The keywords used in searching databases were: early ambulation, rehabilitation and intensive care units and its correlates in Portuguese. The search resulted a total of 202 articles, 171 were excluded by the title or abstract with proposition different. Of the 31 abstracts that were selected, 19 were repeated. Thus, 12 abstracts were selected for reading. Eight review articles were excluded, including all the articles found in Portuguese. Three articles were added from references. The rehabilitation started early seems to bring favorable results for the reversal of muscle weakness acquired by the critical patient, functional status improvement, reduction of MV time and hospital stay. However, more studies are needed that address protocol types, duration, intensity and its impact on the functionality of critical patients.