Efeitos da eletroestimulação neuromuscular nos desfechos clínicos e funcionais de pacientes internados em unidade de terapia intensiva: uma revisão integrativa
Data
2022-01-25
Autores
Ayala, Larissa Aguiar de Souza 
Orientadores
Yamauchi, Liria Yuri
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Avaliar os efeitos da eletroestimulação neuromuscular (EENM) nos desfechos
clínicos e funcionais dos pacientes submetidos à ventilação mecânica (VM) e internados em
Unidade de Terapia Intensiva (UTI). Método: Revisão integrativa de ensaios clínicos
randomizados e estudos de revisão que abordaram intervenções fisioterapêuticas através da
aplicação da eletroestimulação em UTI e submetidos à ventilação mecânica. A busca foi
realizada nas bases de dados: Biblioteca Virtual em Saúde (BVS), PUBMED/MEDLINE,
EMBASE e SCOPUS. Resultados: Foram identificados 1365 estudos e após a exclusão de
345 duplicatas, as pesquisadoras selecionaram 30 artigos com base nos critérios de inclusão
para a leitura na íntegra. Conclusão: Dos 30 artigos, 9 não descreveram ao menos um
desfecho funcional e/ou clínico promovido pela aplicação da EENM. Em relação aos
desfechos clínicos 12 estudos apresentaram menor duração da VM, 7 estudos um menor
período de internação, 6 estudos pontuaram maior número de dias livres da VM, 5 estudos
apresentaram facilitação no processo de extubação e/ou desmame e 3 estudos apontaram
menor mortalidade no grupo EENM. No que tange aos desfechos funcionais foi observado
aumento da força muscular em 19 estudos, melhora da capacidade funcional em 4 estudos e
preservação e/ou aumento da área de secção muscular em 13 dos 30 artigos incluídos.
Identificou-se que a EENM adicionalmente à cinesioterapia possui efeitos mais significativos
nos desfechos clínicos e funcionais dos pacientes internados em UTI desde que as
intervenções tenham uma padronização no formato, duração e momento de início da
aplicação. A intervenção por eletroestimulação, ao combater os efeitos do imobilismo, foi
capaz de promover melhor recuperação e atenuação do quadro crítico de pacientes em
ventilação mecânica invasiva.
Objective: to evaluate the effects of neuromuscular electrical stimulation (NMES) on clinical and functional outcomes of mechanical and ICU patients. Methods: Integrative review of randomized clinical trials and review studies that addressed physical therapy interventions through the application of electrical stimulation in patients hospitalized in an intensive care unit and developments in mechanical ventilation (MV). The search was carried out in the following databases: Virtual Health Library (VHL), PUBMED / MEDLINE, EMBASE and SCOPUS. Results: 1365 studies were identified and after excluding 345 duplicates, the researchers selected 30 articles based on the inclusion criteria for full reading. Conclusion: Of the 30 articles, 9 did not describe at least one functional and/or clinical outcome promoted by the application of the NMES. Regarding clinical outcomes, 12 studies showed shorter duration of MV, 7 studies a shorter hospital stay, 6 studies scored a higher number of days off MV, 5 studies showed facilitation in the extubation and/or weaning process, and 3 studies showed lower mortality in the EENM group. Concerning the functional outcomes, an increase in muscle strength was observed in 19 studies, an improvement in functional capacity in 4 studies, and preservation and/or increase in the muscle section area in 13 of the 30 articles included. It was identified that NMES, in addition to kinesiotherapy, has more significant effects on the clinical and functional outcomes of patients hospitalized in the ICU, as long as the interventions have a standardization in format, duration and time of initiation of application. Intervention by electrical stimulation, by combating the effects of immobility, was able to promote better recovery and attenuation of the critical condition of patients on invasive mechanical ventilation.
Objective: to evaluate the effects of neuromuscular electrical stimulation (NMES) on clinical and functional outcomes of mechanical and ICU patients. Methods: Integrative review of randomized clinical trials and review studies that addressed physical therapy interventions through the application of electrical stimulation in patients hospitalized in an intensive care unit and developments in mechanical ventilation (MV). The search was carried out in the following databases: Virtual Health Library (VHL), PUBMED / MEDLINE, EMBASE and SCOPUS. Results: 1365 studies were identified and after excluding 345 duplicates, the researchers selected 30 articles based on the inclusion criteria for full reading. Conclusion: Of the 30 articles, 9 did not describe at least one functional and/or clinical outcome promoted by the application of the NMES. Regarding clinical outcomes, 12 studies showed shorter duration of MV, 7 studies a shorter hospital stay, 6 studies scored a higher number of days off MV, 5 studies showed facilitation in the extubation and/or weaning process, and 3 studies showed lower mortality in the EENM group. Concerning the functional outcomes, an increase in muscle strength was observed in 19 studies, an improvement in functional capacity in 4 studies, and preservation and/or increase in the muscle section area in 13 of the 30 articles included. It was identified that NMES, in addition to kinesiotherapy, has more significant effects on the clinical and functional outcomes of patients hospitalized in the ICU, as long as the interventions have a standardization in format, duration and time of initiation of application. Intervention by electrical stimulation, by combating the effects of immobility, was able to promote better recovery and attenuation of the critical condition of patients on invasive mechanical ventilation.
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Citação
AYALA, Larissa Aguiar de Souza. Efeitos da eletroestimulação neuromuscular nos desfechos clínicos e funcionais de pacientes internados em unidade de terapia intensiva: uma revisão integrativa. 2022. 26 f. Trabalho de conclusão de curso (Graduação em Fisioterapia) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2022.