Barros-Poblete Marisol, Bernardes Neto Saint-Clair, Benavides-Cordoba Vicente, Vieira Rodolfo P, Baz Manuel, Martí Joan-Daniel, Spruit Martijn A, Torres-Castro Rodrigo
Programa de Doctorado en Ciencias Médicas, Escuela de Graduados Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.
FACISA-Faculdade de Ciências de Saúde do Trairi, Federal University of Rio Grande do Norte, Natal, Brazil.
Front Med (Lausanne). 2022 Nov 21;9:1005732. doi: 10.3389/fmed.2022.1005732. eCollection 2022.
The application of early mobilization (EM) in intensive care units (ICUs) has shown to improve the physical and ventilatory status of critically ill patients, even after ICU stay. This study aimed to describe the practices regarding EM in ICUs in Latin America.
We conducted an observational, cross-sectional study of professionals from all countries in Latin America. Over 3 months, professionals working in ICU units in Latin America were invited to answer the survey, which was designed by an expert committee and incorporated preliminary questions based on studies about EM recommendations.
As many as 174 health professionals from 17 countries completed the survey. The interventions carried out within each ICU were active mobilization (90.5%), passive mobilization (85.0%), manual and instrumental techniques for drainage of mucus secretion (81.8%), and positioning techniques (81%). The professionals who most participated in the rehabilitation process in ICUs were physiotherapists (98.7%), intensive care physicians (61.6%), nurses (56.1%), and respiratory therapists (43.8%). In only 36.1% of the ICUs, protocols were established to determine when a patient should begin EM. In 38.1% of the cases, the onset of EM was established by individual evaluation, and in 25.0% of the cases, it was the medical indication to start rehabilitation and EM.
This report shows us that EM of critically ill patients is an established practice in our ICUs like in other developed countries.
早期活动(EM)在重症监护病房(ICU)中的应用已显示出可改善重症患者的身体和通气状况,即使在患者离开ICU之后。本研究旨在描述拉丁美洲ICU中关于早期活动的实践情况。
我们对拉丁美洲所有国家的专业人员进行了一项观察性横断面研究。在3个多月的时间里,邀请了拉丁美洲ICU病房的专业人员回答由一个专家委员会设计的调查问卷,该问卷纳入了基于有关早期活动建议的研究提出的初步问题。
来自17个国家的174名卫生专业人员完成了调查。每个ICU内实施的干预措施包括主动活动(90.5%)、被动活动(85.0%)、用于排出黏液分泌物的手法和器械技术(81.8%)以及体位技术(81%)。在ICU中参与康复过程最多的专业人员是物理治疗师(98.7%)、重症监护医生(61.6%)、护士(56.1%)和呼吸治疗师(43.8%)。只有36.1%的ICU制定了确定患者何时应开始早期活动的方案。在38.1%的病例中,早期活动的开始是通过个体评估确定的,在25.0%的病例中,是开始康复和早期活动的医学指征。
本报告向我们表明,重症患者的早期活动在我们的ICU中是一种既定的做法,就像在其他发达国家一样。