Correlation of functional status evolution with invasive mechanical ventilation time in critically ill patients
DOI:
https://doi.org/10.11606/issn.2317-0190.v26i4a169465Keywords:
Respiration, Artificial, Critical Care, Activities of Daily Living, Mobility LimitationAbstract
Intensive care patients admitted to the intensive care unit (ICU) usually present a decline in functional status, and the length of stay in invasive mechanical ventilation (IMV) is the most important factor related to impaired physical performance. Objective: To investigate the correlation of the evolution of the functional state between the admission and the rise with the time of VMI made a list of the mobility. Method: This is an observational, cross-sectional study, performed at the ICUs of a state public hospital. Functional Status Score Intensive Care Unit (FSS-ICU) was applied by physiotherapists trained to evaluate functional status. For comparison the groups were divided in clinically and surgically and when the test was used not parametric of Mann-Whitney. The Spearman coefficient was used to analyze the correlation. Results: The sample consisted of 30 patients, 53% male, with median age 49.50 [37.0-67.7] years, median time to IMV 132.00 [48.0-192.0] hours, Charlson comorbidities index 4.0 [2.0-6.0], predominance of the abdominal surgeries (75 %) and median of the FSS between the admission and the high of 12, 0 [10,0-30,7]. There was a moderate to good negative correlation between the FSS of the admission and of the high with the time of VMI in hours (r =-0, 50 p = 0,005) (r =-0, 71 p <0,001). Conclusion: There is a negative correlation between the evolution of the functional state in the admission and high with the time of VMI in critical patients and the diagnostic profile also can interfere in this ending.
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Mondadori AG, Zeni EM, Oliveira A, Silva CC, Wolf VLW, Taglietti M. Humanização da fisioterapia em Unidade de Terapia Intensiva Adulto: estudo transversal. Fisioter Pesq. 2016;23(3):294-300. Doi: http://dx.doi.org/10.1590/1809-2950/16003123032016
Reis LCC, Gabarra LM, Moré CLOO. As repercussões do processo de internação em UTI adulto na perspectiva de familiares. Temas Psicol. 2016;24(3):815-28. Doi: http://dx.doi.org/10.9788/TP2016.3-03
Santos LJ, Silveira FS, Muller FF, Araújo HD, Comerlato JB, Silva MC, et al. Avaliação funcional de pacientes internados na unidade de terapia intensiva adulto do Hospital Universitário de Canoas. Fisioter Pesq. 2017;24(4):437-43. Doi: https://doi.org/10.1590/1809-2950/17720924042017
Silva FRR, Souza TB, Dias MS, Silva APP, Oliveira KC, Oliveira MML, et al. Avaliação da capacidade funcional dos pacientes em uso de ventilação mecânica internados em uma Unidade de Terapia Intensiva. Rev HUPE. 2017;16(1):6-15. Doi: http://dx.doi.org/10.12957/rhupe.2017.33299
Ferreira NA, Lopes AJ, Ferreira AS, Ntoumenopoulos G, Dias J, Guimaraes FS. Determination of functional prognosis in hospitalized patients following an intensive care admission. World J Crit Care Med. 2016;5(4):219-227. Doi: http://dx.doi.org/10.5492/wjccm.v5.i4.219
Jesus FS, Paim DM, Brito JO, Barros IA, Nogueira TB, Martinez BP, et al. Mobility decline in patients hospitalized in an intensive care unit. Rev Bras Ter Intensiva. 2016;28(2):114-9. Doi: http://dx.doi.org/10.5935/0103-507X.20160025
Curzel J, Forgiarini Júnior LA, Rieder MM. Avaliação da independência funcional após alta da unidade de terapia intensiva. Rev Bras Ter Intensiva. 2013;25(2):93-8. Doi: https://doi.org/10.5935/0103-507X.20130019
Martinez BP, Bispo AO, Duarte ACM, Gomes Neto M. Declínio funcional em uma unidade de terapia intensiva (UTI). Rev Inspirar Mov Saúde. 2013;5(1):1-5.
Gomes RHS, Santos RS. Avaliação da capacidade e comprometimento funcional em pacientes traqueotomizados de um hospital público de Curitiba. Rev CEFAC. 2016;18(1):120-8. Doi: https://doi.org/10.1590/1982-021620161813715
Cordeiro AL, Melo TA, Santos AM, Lopes GF. Influência do tempo de ventilação mecânica sobre a independência funcional em pacientes submetidos à cirurgia cardíaca: uma revisão da literatura. Fisioter Mov. 2015;28(4):859-64. Doi: http://dx.doi.org/10.1590/0103-5150.028.004.AR04
Costa FM, Correa ADB, Narala Neto E, Vieira EMM, Lima E, Nasrala MLS, et al. Avaliação da funcionalidade motora em pacientes com tempo prolongado de internação hospitalar. UNOPAR Cient Ciênc Biol Saúde. 2014;16(2):87-91. Doi: https://doi.org/10.17921/2447-8938.2014v16n2p%25p
Cordeiro ALL, Brito AAOR, Santana NMA, Silva INMS, Nogueira SCO, Guimarães ARF, et al. Análise do grau de independência funcional pré e na alta da Unidade de Terapia Intensiva em pacientes submetidos à cirurgia cardíaca. Rev Pesq Fisioter. 2015; 5(1):21-27. Doi: http://dx.doi.org/10.17267/2238-2704rpf.v5i1.574
Calvo-Ayala E, Khan BA, Farber MO, Ely EW, Boustani MA. Interventions to improve the physical function of ICU survivors: a systematic review. Chest. 2013;144(5):1469-1480. Doi: http://dx.doi.org/10.1378/chest.13-0779
Silva VZM, Araujo Neto JA, Cipriano Junior G, Pinedo M, Needham DM, Zanni JM, et al. Versão brasileira da Escala de Estado Funcional em UTI: tradução e adaptação transcultural. Rev Bras Ter Intensiva. 2017;29(1):34-8. Doi: http://dx.doi.org/10.5935/0103-507X.20170006
Christakou A, Papadopoulos E, Patsaki I, Giorgos S, Serafeim N. Functional Assessment Scales in a General Intensive Care Unit. A review. Hospital Chronicles. 2013;8(4):164-70. Doi: https://doi.org/10.2015/hc.v8i4.552
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. Doi: http://dx.doi.org/10.1016/0021-9681(87)90171-8
Iucif JRN, Rocha JSY. Estudo da desigualdade na mortalidade hospitalar pelo índice de comorbidades de Charlson. Rev Saúde Pública. 2004;38(6):780-6. Doi: https://doi.org/10.1590/S0034-89102004000600005
Portney LG, Watkins MP. Foundations of clinical research – applications to pratice. Connecticut; Appleton& Lange; 1997.
CIF: Classificação Internacional de Funcionalidade, Incapacidade e Saúde. São Paulo: Edusp; 2003.
Levack K. The International Classification of Functioning, Disability and Health (ICF): applications to physiotherapy. NZJP. 2004;32:1-2.
Thrush A, Rozek M, Dekerlegand JL. The clinical utility of the functional status score for the intensive care unit (FSS-ICU) at a long-term acute care hospital: a prospective cohort study. Phys Ther. 2012;92(12):1536-45. Doi: http://dx.doi.org/10.2522/ptj.20110412
Hodgson C, Bellomo R, Berney S, Bailey M, Buhr H, Denehy L, et al. Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study. Crit Care. 2015;19(1):81. Doi: http://dx.doi.org/10.1186/s13054-015-0765-4
Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82. Doi: http://dx.doi.org/10.1016/S0140-6736(09)60658-9
Hodgson CL, Stiller K, Needham DM, Tipping CJ, Harrold M, Baldwin CE, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care. 2014;18(6):658. Doi: http://dx.doi.org/10.1186/s13054-014-0658-y
Fonseca L, Vieira FN, Azzolin KO. Fatores associados ao tempo de ventilação mecânica no pós-operatório de cirurgia cardíaca. Rev Gaucha Enferm. 2014;35(2):67-72. Doi: http://dx.doi.org/10.1590/1983-1447.2014.02.44697
Bragança HCE, Rezende AAB, Reis GR, Magagnin JLS, Miranda EF, Rodrigues ESR, et al. Correlação entre níveis de sedação e tempo de ventilação mecânica. Rev Amazônia Science & Health. 2014;2(2):15-20.
Shehabi Y, Bellomo R, Reade MC, et al. Early intensive care sedation predicts long-term mortality in ventilated critically ill patients. Am J Respir Crit Care Med. 2012;186(8):724‐731. Doi: http://dx.doi.org/10.1164/rccm.201203-0522OC
Strøm T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet. 2010;375(9713):475-80. doi: Doi: http://dx.doi.org/10.1016/S0140-6736(09)62072-9
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