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

IF 0.7 Q4 NURSING Enfermeria Clinica Pub Date : 2023-05-01 DOI:10.1016/j.enfcli.2022.11.001

Paulo Azevedo , Bárbara Gomes , José Macedo , Soraia Ferreira , José Pereira , Ana Pires

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Abstract

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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危重病人肌肉无力:系统化护理康复计划的影响

重症监护病房获得性肌无力(ICUAW)在危重患者中很常见，并与不良预后相关。早期康复是改善结果的一种策略。目的是评估康复护理方案在重症监护室出院时的效果。方法采用系统护理康复方案组与常规护理康复方案组进行对比研究。2017年6月至2019年6月，在一家大型葡萄牙语教学医院的三个重症监护室，对42名危重通气患者进行非概率序列抽样，其中21名患者为对照组，21名患者为干预组。采用Mann-Whitney检验比较两组间医学研究委员会总评分(MRC-SS)值。结果接受康复治疗的患者ICUAW明显降低(ICU出院时MRC-SS = 38 vs. MRC-SS = 42.7;p = 0.043;u = 152.5)。严重肌无力(9.5% vs. 28.6%)和明显肌无力(42.9% vs. 52.4%)减少，无肌无力增加(47.6% vs. 19%)。结论系统的康复护理方案可提高重症患者出院时的肌力，减少功能障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Enfermeria Clinica NURSING-

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nursing professionals from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. The aim of the Journal is to promote increased knowledge through the publication of original research and other studies that may help nursing professionals improve their daily practice. This objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Special Articles, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes comments about original articles of special interest written by experts.