Consequencias do estado nutricional na força muscular respiratória de idosos hospitalizados assistidos pela fisioterapia
Consequences of the nutritional status in the respiratory muscle force in hospitalized elderly treated with physiotherapy
Eliane Regina Ferreira Sernache de Freitas, Caroline Mari Oyama, Priscila Silva Oliveira, Leila Donária, Antonio Fernando Brunetto
Resumo
Introdução: O estado nutricional pode afetar as necessidades fisiológicas, determinando alterações na função respiratória de idosos hospitalizados. Objetivo: Avaliar os efeitos do estado nutricional na força muscular respiratória em idosos hospitalizados assistidos pela fisioterapia. Métodos: Foram estudados 30 indivíduos com idade igual ou acima de 60 anos internados no Hospital Santa Casa de Londrina pelo sistema único de saúde (SUS) e divididos em dois grupos: grupo 1 (G1) - pacientes com até 12 horas de solicitação médica para assistência de fisioterapia e grupo 2 (G2) - pacientes que não tinham solicitação médica de acompanhamento fisioterapêutico. Foi realizado o teste de força muscular respiratória e avaliação das variáveis do estado nutricional considerando-se parâmetros antropométricos, laboratoriais e determinação da competência imune. Resultado: O sobrepeso predominou nos dois grupos em especial no G1 (p=0,0272). Idosos do G1 apresentaram um menor percentual do valor predito de força muscular respiratória (PImax 58 ± 26,4 e PEmax 62 ± 21,1). O diagnóstico predominante foi de insuficiência cardíaca congestiva (40%) nos dois grupos, sendo que no G1 foi de 23,3% e no G2 16,7%. O G1 apresentou um número maior de idosos com diminuição de hemoglobina e aumento dos leucócitos totais. Conclusão: Não foi evidenciada a depleção do estado nutricional nos idosos estudados, mas sim o sobrepeso. Contudo, a diferença clínica encontrada, com diminuição da PImax e PEmax no G1, reforça a necessidade de uma intervenção fisioterapêutica precoce em pacientes idosos hospitalizados no sentido de otimizar sua força muscular respiratória, prevenindo maiores complicações pulmonares com conseqüente diminuição do tempo de permanência hospitalar e custos com os cuidados à saúde.
Palavras-chave
Abstract
Introduction: The nutritional status can affect the physiological needs, determining changes in lung function in elderly patients. Objective: To evaluate the effects of nutritional status in the respiratory muscle force in elderly subjects treated with physiotherapy. Methods: We studied 30 subjects over 60 years old hospitalized at the Hospital Santa Casa in Londrina by the Public Health System and divided into two groups: group 1 (G1) - patients until 12 hours of medical solicitation for physiotherapy attendance and group 2 (G2) – patients who did not have medical solicitation for physiotherapy. Respiratory muscle force and nutritional status were assessed. Immune competence was also evaluated. Results: Overweight prevailed in the two groups especially in G1 (p=0.0272). The elderly in G1 had lower values of respiratory muscle force (MIP 58 ± 26.4 % predicted and MEP 62 ± 21.1 % predicted). The most predominant diagnosis was chronic heart failure (40%) in the two groups, and in G1 was of 23.3% whereas in G2 16.7%. G1 presented a larger number of elderly with hemoglobin decrease and total leukocytes increase. Conclusion: There was no significant depletion in these elderly hospitalized subjects, but overweight instead. However, the decreased MIP and MEP in G1 increases the need for an early physical therapy intervention in hospitalized elderly patients in order to optimize their respiratory muscle force, preventing major pulmonary complications with consequent reduction in length of hospital stay and healthcare costs.
Keywords
Referências
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