Segurança da aplicação da estimulação elétrica neuromuscular em pacientes críticos
Safety of neuromuscular electrical stimulation in critical patients
SACHETTI, Amanda; DALL’ACQUA, Ana Maria; BIANCHI, Tanara; NAUE, Wagner; SANTOS, Laura Jurema dos; DIAS, Alexandre Simões.
Resumo
Introdução: Uma das técnicas empregadas no ambiente de terapia intensiva, na busca pela saída precoce da ventilação mecânica invasiva (VMI), é a eletroestimulação neuromuscular (EENM). Objetivo: Avaliar a segurança da técnica de EENM em pacientes críticos em VMI. Métodos: Ensaio clínico randomizado duplo cego, com 24 pacientes em ventilação mecânica invasiva, divididos em grupo intervenção (EENM + fisioterapia convencional) e controle (EENM placebo + fisioterapia convencional). Foram avaliados: lactato sanguíneo, complacência pulmonar dinâmica e variáveis cardiorrespiratórias (frequência cardíaca (FC), frequência respiratória (FR), saturação de oxigênio (SATO2) e pressão arterial (PA)), antes e após aplicação de um protocolo de EENM. Para análise estatística, as variáveis contínuas foram descritas como média e desvio padrão ou mediana e amplitude interquartil e as categóricas por frequências absolutas e relativas. Para comparar médias entre os grupos, o Teste t-student para amostras independentes foi aplicado. Resultados: Nenhuma das variáveis apresentou diferença estatisticamente significativa entre os momentos e nenhum efeito adverso foi relatado. Conclusão: A técnica de EENM é segura, para ser realizada em ambientes críticos; porém, algumas adaptações do ambiente são importantes, para maior segurança, durante a realização.
Palavras-chave
Abstract
Introduction: neuromuscular electrostimulation (NMES) is one of the techniques used in the intensive care unit, in the search of early weaning of invasive mechanical ventilation (IMV). Objective: to evaluate the safety of NMES technique in critical patients under IMV. Methods: A randomized double-blind clinical trial with 24 patients under IMV, divided into intervention group (NMES + conventional physiotherapy) and control group (NMES placebo + conventional physiotherapy). Blood lactate, dynamic pulmonary compliance and cardiorespiratory variables (heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2 ) and blood pressure (BP) were evaluated before and after applying the NMES protocol. For the statistical analysis, continuous variables were described as mean and standard deviation or median and interquartile range, and categorical variables by absolute and relative frequencies. To compare means between groups, the student’s t-test for independent samples was applied. Results: None of the variables presented a statistically significant difference between the moments and none adverse effects were reported. Conclusion: NMES is safe to perform in critical environments but a few adaptations of the environment are important for greater safety during performance.
Keywords
Referências
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