Protocolos de exercícios para mobilização precoce em pacientes sob ventilação mecânica: uma revisão integrativa
Data
2024-11-19
Autores
Herreiro, Vitória 
Orientadores
Yamauchi, Liria Yuri
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: O objetivo do presente estudo foi identificar, por meio de uma análise detalhada da literatura, vinte e quatro protocolos de mobilização precoce e avaliar sua replicabilidade, com ênfase na dosagem e intensidade das intervenções aplicadas em pacientes adultos, internados em Unidades de Terapia Intensiva (UTIs) e sob ventilação mecânica. Métodos: Este estudo é uma revisão integrativa da literatura. Uma busca foi realizada no dia 27 de agosto de 2024 nas bases de dados: BVS, PubMed/Medline e Scopus. Foram pesquisados artigos disponíveis eletronicamente nesta data, que estivessem nos idiomas português, inglês e espanhol, abrangendo publicações do período de 2014 a 2024. A revisão iniciou com a esquematização de uma pergunta norteadora, sendo “Qual seria a dosagem/intensidade dos exercícios de mobilização precoce aplicados em pacientes sob ventilação mecânica na UTI?”. Foram incluídos artigos que descrevessem indivíduos adultos com idade superior a 18 anos, em ventilação mecânica por um período mínimo de 24h, e que correspondem à categoria de ensaios clínicos randomizados e excluídas revisões sistemáticas, estudos de coorte e caso-controle, meta-análises, estudos descritivos, transversais, longitudinais e qualitativos. Resultado: Inicialmente foram identificados 315 artigos por meio da busca nas bases de dados selecionadas. Após a remoção das duplicatas e a exclusão dos estudos que não atendiam aos critérios de inclusão estabelecidos, esse número foi reduzido para 35 artigos. Em seguida, procedeu-se à leitura completa desses 35 artigos, resultando na exclusão justificada de 11 deles por não se adequarem aos critérios da pesquisa. Ao final desse processo de triagem, 24 artigos foram considerados elegíveis e selecionados para compor a presente revisão. Ademais, as diretrizes do Consensus on Exercise Reporting Template (CERT) foram utilizadas para avaliar o detalhamento de informações de cada estudo e sua respectiva replicabilidade. Conclusão: Dos 24 estudos avaliados, apenas seis atenderam a todos os critérios analisados pelo CERT neste trabalho, abrangendo aspectos cruciais como replicabilidade, dosagem e intensidade. Os outros 18 estudos não cumpriram integralmente os requisitos estabelecidos. Essa lacuna compromete de maneira significativa a replicabilidade das práticas fisioterapêuticas em Unidades de Terapia Intensiva (UTIs) globalmente, dificultando que outros profissionais de saúde implementem essas intervenções de forma eficaz e segura.
Objective: The aim of the present study was to identify, through a detailed analysis of the literature, twenty-four early mobilization protocols and evaluate their replicability, with emphasis on the dosage and intensity of the interventions applied to adult patients admitted to Intensive Care Units (ICUs) and under mechanical ventilation. Methods: This study is an integrative literature review. A search was carried out on August 27, 2024 in the following databases: BVS, PubMed/Medline and Scopus. Articles available electronically on that date, which were in Portuguese, English and Spanish, were searched, covering publications from 2014 to 2024. The review began with the outline of a guiding question, namely “What would be the dosage/intensity of early mobilization exercises applied to patients under mechanical ventilation in the ICU?”. Articles describing adults over 18 years of age on mechanical ventilation for a minimum period of 24 hours and corresponding to the category of randomized clinical trials were included. Systematic reviews, cohort and case-control studies, meta-analyses, descriptive, cross-sectional, longitudinal and qualitative studies were excluded. Results: Initially, 315 articles were identified through the search in the selected databases. After removing duplicates and excluding studies that did not meet the established inclusion criteria, this number was reduced to 35 articles. These 35 articles were then read in full, resulting in the justified exclusion of 11 of them because they did not meet the research criteria. At the end of this screening process, 24 articles were considered eligible and selected to compose the present review. Furthermore, the Consensus on Exercise Reporting Template (CERT) guidelines were used to assess the detail of information in each study and its respective replicability. Conclusion: Of the 24 studies evaluated, only six met all the criteria analyzed by CERT in this study, covering crucial aspects such as replicability, dosage and intensity. The other 18 studies did not fully meet the established requirements. This gap significantly compromises the replicability of physiotherapy practices in Intensive Care Units (ICUs) globally, making it difficult for other health professionals to implement these interventions effectively and safely.
Objective: The aim of the present study was to identify, through a detailed analysis of the literature, twenty-four early mobilization protocols and evaluate their replicability, with emphasis on the dosage and intensity of the interventions applied to adult patients admitted to Intensive Care Units (ICUs) and under mechanical ventilation. Methods: This study is an integrative literature review. A search was carried out on August 27, 2024 in the following databases: BVS, PubMed/Medline and Scopus. Articles available electronically on that date, which were in Portuguese, English and Spanish, were searched, covering publications from 2014 to 2024. The review began with the outline of a guiding question, namely “What would be the dosage/intensity of early mobilization exercises applied to patients under mechanical ventilation in the ICU?”. Articles describing adults over 18 years of age on mechanical ventilation for a minimum period of 24 hours and corresponding to the category of randomized clinical trials were included. Systematic reviews, cohort and case-control studies, meta-analyses, descriptive, cross-sectional, longitudinal and qualitative studies were excluded. Results: Initially, 315 articles were identified through the search in the selected databases. After removing duplicates and excluding studies that did not meet the established inclusion criteria, this number was reduced to 35 articles. These 35 articles were then read in full, resulting in the justified exclusion of 11 of them because they did not meet the research criteria. At the end of this screening process, 24 articles were considered eligible and selected to compose the present review. Furthermore, the Consensus on Exercise Reporting Template (CERT) guidelines were used to assess the detail of information in each study and its respective replicability. Conclusion: Of the 24 studies evaluated, only six met all the criteria analyzed by CERT in this study, covering crucial aspects such as replicability, dosage and intensity. The other 18 studies did not fully meet the established requirements. This gap significantly compromises the replicability of physiotherapy practices in Intensive Care Units (ICUs) globally, making it difficult for other health professionals to implement these interventions effectively and safely.
Descrição
Citação
HERREIRO, Vitória. Protocolos de exercícios para mobilização precoce em pacientes sob ventilação mecânica: uma revisão integrativa. 2024. 47 f. Trabalho de conclusão de curso (Graduação em Fisioterapia) - Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Santos, 2024.