Efeitos da eletroestimulação em pacientes internados em unidade de terapia intensiva: revisão sistemática
Effects of electrical stimulation in patients admitted to the intensive care unit: a systematic review
Lucas Lima Ferreira, Luiz Carlos Marques Vanderlei, Vitor Engrácia Valenti
Resumo
Introdução: A fraqueza muscular do paciente crítico é um dos problemas mais comuns em pacientes internados em Unidade de Terapia Intensiva (UTI), sendo, a mobilização precoce e a estimulação elétrica (EE), técnicas comumente aplicadas pelo fisioterapeuta para reversão do quadro. Objetivo: Analisar os desfechos propiciados pela EE, em pacientes críticos e assistidos em UTI. Métodos: Revisão sistemática de literatura, por meio de ensaios clínicos publicados entre 2002 e 2012. A busca envolveu as bases de dados LILACS, SciELO, MedLine e PEDro, usando os descritores “intensive care unit”, “physical therapy”, “physiotherapy”, “electric stimulation” e “randomized controlled trials”. Resultados: De uma análise inicial de 43 estudos, apenas quatro contemplaram os critérios de seleção e abordaram os desfechos pretendidos. O tamanho amostral variou entre 8 a 33 sujeitos, de ambos os gêneros, com média de idade entre 52 e 79 anos, submetidos à ventilação mecânica invasiva. Dos artigos analisados, três indicaram benefícios significativos da EE, em pacientes críticos, como melhora na força muscular periférica, capacidade de exercício, funcionalidade ou espessura de perda da camada muscular. Conclusão: A aplicação de eletroestimulação promove uma resposta benéfica em pacientes críticos internados em UTI.
Palavras-chave
Abstract
Introduction: Muscle weakness in critically ill patients is one of the most common problems in patients admitted to the intensive care unit (ICU), and early mobilization and electrical stimulation (ES) techniques are commonly applied by the physiotherapist to reverse this picture. Objective: To analyze the outcomes enabled by the ES in critically ill patients assisted in ICU. Methods: A systematic literature review of clinical trials published between 2002 and 2012. The search involved the databases LILACS, SciELO, MEDLINE and PEDro using the descriptors intensive care unit, physical therapy, physiotherapy, electric stimulation and randomized controlled trials. Results: From an initial analysis of 43 studies, only four met the selection criteria and addressed the outcomes desired. The sample size varied between 8 and 33 individuals of both genders, with ages ranging between 52 and 79 years, undergoing invasive mechanical ventilation. From the analyzed articles, three of them showed significant benefits of the ES in critically ill patients, such as improvement in peripheral muscle strength, exercise capacity, functionality, or loss of thickness of the muscle layer. Conclusion: The application of the electrical stimulation promotes a beneficial response in critically ill patients in the ICU.
Keywords
Referências
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