Functional status of adults undergoing orotracheal intubation at discharge from the Intensive Care Unit
DOI:
https://doi.org/10.33448/rsd-v14i3.48519Keywords:
Intensive Care Unit, Mechanical Ventilation, Orotracheal Intubation, Functional Capacity, Weakness Acquired in the ICU, Critical Patient.Abstract
Patients admitted to intensive care units undergo a series of invasive treatments, bed rest, and the systemic inflammatory response of the underlying disease, and are susceptible to musculoskeletal changes and reduced functionality. This study aimed to assess the functional status of young adults who underwent orotracheal intubation upon discharge from intensive care. This is a cross-sectional, quantitative, observational, and field research study with an applied purpose. Patients aged 18 to 44 years who remained in the ICU for more than 72 hours were included. Sociodemographic data, history of current illness and clinical evolution in the ICU, mobility assessment (ICU Mobility Scale), functional assessment (Functional Independence and Measurement), assessment of peripheral muscle strength (Medical Research Council), and assessment of respiratory muscle strength (manovacuometry) were collected. The sample consisted of 9 individuals with a mean age of 28 years, 88.9% of whom were male. The average length of stay in the ICU was 17.7 days, and they were intubated for an average of 12.9 days. The results of the peripheral muscle strength scale showed that 100% had a diagnosis of muscle weakness acquired in the ICU. It was observed that 77.8% had changes in the respiratory muscles through MIP values, and 88.9% had MEP values below normal. It was also possible to observe changes in functionality in 78.8% of the participants. The results indicated satisfactory mobility, where the majority were able to walk with or without assistance. Finally, it was observed that even with peripheral and respiratory muscle weakness, and changes in functionality, the mobility of the participants was preserved.
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Abentroth, L. R. L., Osaku, E. F., Silva, M. M. M. da, Jaskowiak, J. L., Zaponi, R. de S., Ogasawara, S. M., Leite, M. A., Costa, C. R. L. de M., Porto, I. R. P., Jorge, A. C. & Duarte, P. A. D. (2021). Independência funcional e espirometria em pacientes adultos pós-unidade de terapia intensiva. Revista Brasileira de Terapia Intensiva, 33, 243–50. https://doi.org/10.5935/0103-507X.20210031.
Alves, G. A. de A., Martinez, B. P., & Lunardi, A. C. (2019). Assessment of the measurement properties of the Brazilian versions of the Functional Status Score for the ICU and the Functional Independence Measure in critically ill patients in the intensive care unit. Revista Brasileira de Terapia Intensiva, 31(4), 521–8. https://doi.org/10.5935/0103-507X.20190065.
ATS/ACCP (2003). American Thoracic Society, & American College of Chest Physicians. (2003). ATS/ACCP Statement on Cardiopulmonary Exercise Testing. American Journal of Respiratory and Critical Care Medicine, 167(2), 211–77. https://doi.org/10.1164/rccm.167.2.211.
Bureau, C., Van Hollebeke, M. & Dres, M. (2023). Managing respiratory muscle weakness during weaning from invasive ventilation. European Respiratory Review, 32(168), 220205. https://doi.org/10.1183/16000617.0205-2022.
Campos, C. G. P., Pacheco, A., Gaspar, M. D. da R., Arcaro, G., Reche, P. M., Nadal, J. M. & Farago, P. V. (2021). Analysis of diagnostic criteria for ventilator-associated pneumonia: a cohort study. Revista Brasileira de Enfermagem, 74. https://doi.org/10.1590/0034-7167-2019-0653.
Clerk, A. M., Shah, R. J., Kothari, J., Sodhi, K., Vadi, S., Bhattacharya, P. K. & Mishra, R. C. (2024). Position Statement of ISCCM Committee on Weaning from Mechanical Ventilator. Indian Journal of Critical Care Medicine, 28(S2), S233–S248. https://doi.org/10.5005/jp-journals-10071-24716.
Curzel, J., Forgiarini Junior, L. A. & Rieder, M. de M. (2013). Evaluation of functional independence after discharge from the intensive care unit. Revista Brasileira de Terapia Intensiva, 25, 93–8. https://doi.org/10.5935/0103-507X.20130019.
D’Andrea, A., Le Peillet, D., Fassier, T., Prendki, V., Trombert, V., Reny, J-L. & Roux, X. (2020). Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01729-y.
Elkalawy H., Sekhar, P. & Wael Abosena. (2023). Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review. Acute and Critical Care, 38(4), 409–24. https://doi.org/10.4266/acc.2023.00703.
Ji H. M. & Won Y. H. (2024). Early Mobilization and Rehabilitation of Critically-ill Patients. Tuberculosis & Respiratory Diseases, 87(2), 115–22. https://doi.org/10.4046/trd.2023.0144.
Kawaguchi, Y. M. F., Nawa, R. K., Figueiredo, T. B., Martins, L. & Pires-Neto, R. C. (2016). Perme Intensive Care Unit Mobility Score and ICU Mobility Scale: translation into Portuguese and cross-cultural adaptation for use in Brazil. Jornal Brasileiro de Pneumologia, 4 (6), 429–34. https://doi.org/10.1590/s1806-37562015000000301.
Latronico, N., Rasulo, F., Eikermann, M. & Piva, S. (2023). Illness Weakness, Polyneuropathy and Myopathy: Diagnosis, treatment, and long-term outcomes. Critical Care, 27(1). https://doi.org/10.1186/s13054-023-04676-3.
Mahbub, M., Srinivasan, S., Danciu, I., Peluso, A., Begoli, E., Tamang, S. & Peterson, G. D. (2022). Unstructured clinical notes within the 24 hours since admission predict short, mid & long-term mortality in adult ICU patients. PLOS ONE, 17(1), e0262182. https://doi.org/10.1371/journal.pone.0262182.
Ozdemir, M., Bomkamp, M. P., Hyatt, H. W., Smuder, A. J. & Powers, S. K. (2022). Intensive Care Unit Acquired Weakness Is Associated with Rapid Changes to Skeletal Muscle Proteostasis. Cells, 11(24), 4005. https://doi.org/10.3390/cells11244005.
Özsoy İ., Özcan Kahraman B., Kahraman T., Tanrıverdi A., Acar S., Özpelit E., Şentürk B., Akdeniz B. & Savcı S. (2021). Assessment of psychometric properties, cross-cultural adaptation, and translation of the Turkish version of the ICU mobility scale. Turk J Med Sci. 51(3), 1153-7. https://doi.org/10.3906/sag-2005-319.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Editora UAB/NTE/UFSM.
Pereira, G. B., Silveira, K. L., Luciane, C. & Mandagará, M. (2020). Características clínicas de usuários abusivos de substâncias psicoativas internados em Unidade de Terapia Intensiva. SMAD, Rev. Eletrônica Saúde Mental Alcool Drog, 34–41. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1127296.
Riberto, M., Miyazaki, M. H., Jucá, S. S. H., Sakamoto, H., Pinto, P. P. N. & Battistella, L. R. (2004). Validação da Versão Brasileira da Medida de Independência Funcional. Acta Fisiátrica, 11(2), 72–6. https://doi.org/10.5935/0104-7795.20040003.
Santos Filho, A. B. de A., Santos, J. G. C. dos, Santos, E. A. dos & Alves, A. S. S. (2022). Diagnóstico fisioterapêuticos na Unidade de Terapia Intensiva (UTI): revisão integrativa. Research, Society and Development, 11(9), e35511932107. https://doi.org/10.33448/rsd-v11i9.32107.
Santos, M. R. dos, Guerreiro, C. F., Anjos, J. L. M. & Silva, C. M. da S. e. (2019). Correlação da evolução do estado funcional com o tempo de ventilação mecânica invasiva em pacientes críticos. Acta Fisiátrica, 26(4), 181–5. https://doi.org/10.11606/issn.2317-0190.v26i4a169465.
Shitsuka, R. et al. (2014). Matemática fundamental para tecnologia. (2ed.). Editora Erica.
Silveira, B. M. F., Martins, H. R., Ribeiro-Samora, G. A., Oliveira, L. F., Mancuzo, E. V., Velloso, M. & Parreira, V. F. (2023). Maximal respiratory pressures: Measurements at functional residual capacity in individuals with different health conditions using a digital manometer. Brazilian Journal of Physical Therapy, 27 (4), 100529. https://doi.org/10.1016/j.bjpt.2023.100529.
Tipping, C. J., Bailey, M. J., Bellomo, R., Berney, S., Buhr, H., Denehy, L., Harrold, M., Holland, A., Higgins, A. M., Iwashyna, T. J., Needham, D., Presneill, J., Saxena, M., Skinner, E. H., Webb, S., Young, P., Zanni, J. & Hodgson, C. L. (2016). The ICU Mobility Scale Has Construct and Predictive Validity and Is Responsive. A Multicenter Observational Study. Annals of the American Thoracic Society, 13(6), 887–93. https://doi.org/10.1513/annalsats.201510-717oc.
Tornari, C., Surda, P., Takhar, A., Amin, N., Dinham, A., Harding, R., Ranford, D. A., Archer, S. K., Wyncoll, D., Tricklebank, S., Ahmad, I., Simo, R. & Arora, A. (2020). Tracheostomy, ventilatory wean, and decannulation in COVID-19 patients. European Archives of Oto-Rhino-Laryngology, 278(5), 1595–604. https://doi.org/10.1007/s00405-020-06187-1.
Tran, D. H., Maheshwari, P., Nagaria, Z., Patel, H. Y. & Verceles, A. C. (2020). Ambulatory Status Is Associated With Successful Discharge Home in Survivors of Critical Illness. Respiratory Care, 65(8), 1168–73. https://doi.org/10.4187/respcare.07437.
Vanhorebeek, I., Latronico, N. & Van den Berghe, G. (2020). ICU-acquired Weakness. Intensive Care Medicine, 46(4), 637–53. https://doi.org/10.1007/s00134-020-05944-4.
Vento, D. A., Faria, A. M., Silva, L. G., Ferreira, J. C. M. & Guimarães, V. A. (2018). Utilização da escala do medical research council no desmame em pacientes críticos. Revista Educação em Saúde, 6(2), 125–32. https://doi.org/10.29237/2358-9868.2018v6i2.p125-132.
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