Debilidad muscular en pacientes críticos: efectos de un programa de rehabilitación sistematizado de enfermería

• Paulo Azevedo ^[1] ; Bárbara Gomes ^[2] ; José Macedo ^[3] ; Soraia Ferreira ^[4] ; José Pereira ^[5] ; Ana Pires ^[3]
  1. [1] Portuguese Red Cross Northern Health School, Rua da Cruz Vermelha, Cidacos, Oliveira de Azeméis, Portugal
  2. [2] Escola Superior de Enfermagem do Porto, Porto, Portugal
  3. [3] Unidade de Cuidados Intensivos Polivalente Geral, Centro Hospitalar São João, Porto, Portugal
  4. [4] Unidade de Cuidados Intensivos Polivalente da Urgência, Centro Hospitalar São João, Porto, Portugal
  5. [5] Serviço de Neurocríticos, Centro Hospitalar São João, Porto, Portugal

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• Localización: Enfermería clínica, ISSN 1130-8621, Vol. 33, Nº. 3, 2023, págs. 216-222
• Idioma: español
• DOI: 10.1016/j.enfcli.2022.11.001
• Títulos paralelos:
  • Muscle weakness in critically ill patients: Effects of a systematized rehabilitation nursing program
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• Resumen
  • español

    Objetivo La debilidad adquirida en la unidad de cuidados intensivos (DAUCI) en pacientes críticos es frecuente, y se asocia a resultados negativos. La rehabilitación es una estrategia para mejorar los resultados. El propósito de este estudio fue evaluar los efectos de un programa de enfermería de rehabilitación al recibir el alta de la unidad de cuidados intensivos.

    Métodos Estudio cuasi-experimental, en el que se comparan pacientes que se sometieron a cuidados habituales de rehabilitación de enfermería y pacientes que se sometieron a un programa de enfermería de rehabilitación sistematizado. Muestra no probabilística secuencial de 42 pacientes críticos ventilados, 21 pacientes en el grupo de control y 21 pacientes en el grupo de intervención (de junio 2017 a junio 2019), en 3 unidades de cuidados intensivos de un gran hospital universitario portugués. Se realizó la prueba de Mann-Whitney para comparar los valores de la puntuación total del Medical Research Council Sum Score (MRC-SS) entre los grupos.

    Resultados Los pacientes que recibieron el programa de rehabilitación sistematizado, presentaron una disminución de la DAUCI en el momento del alta de la UCI (media de MRC-SS=38 vs. media de MRC-SS=42,7; p=0,043; U=152,5). Se produjo una disminución de la debilidad muscular severa (9,5 vs. 28,6%) y debilidad muscular significativa (42,9 vs. 52,4%) y un aumento de pacientes sin debilidad muscular (47,6 vs. 19%).

    Conclusiones El programa de enfermería de rehabilitación sistemática puede mejorar la fuerza muscular, y reducir la incapacidad funcional en el momento del alta de cuidados intensivos.

  • English

    Objective Intensive care unit-acquired muscle weakness (ICUAW) in critically ill patients is frequent and associated with negative outcomes. Early rehabilitation is a strategy to improve outcomes. The aim was to assess the effects of a rehabilitation nursing programme at discharge from intensive care unit.

    Methods Quasi-experimental study with the comparison between two groups: one enrolled in a systematized nursing rehabilitation program and the other with usual nursing rehabilitation care. A non-probabilistic sample, sequential, of 42 critically ill ventilated patients, 21 patients in the control group and 21 patients the intervention group (June 2017 to June 2019), in three intensive care units of one large Portuguese teaching hospital. Mann-Whitney test was performed to compare Medical Research Council Sum Score (MRC-SS) values between groups.

    Results Patients undergoing the rehabilitation program had a decrease in ICUAW (at ICU discharge mean MRC-SS=38 vs. mean MRC-SS=42.7; p=0.043; U=152.5). There was a decrease in severe muscle weakness (9.5% vs. 28.6%) and significant muscle weakness (42.9% vs. 52.4%) and an increase without muscle weakness (47,6% vs. 19%).

    Conclusions The systematic rehabilitation nursing program can improve muscle strength and reduce functional disability at the time of discharge from intensive care.

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