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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versão impressa ISSN 2448-8909

Resumo

LOPEZ-ESQUIVEL, Yasmín Nancy; CARRILLO-RAMIREZ, Silvia del Carmen; ESPONDA-PRADO, Juan Gerardo  e  MORENO-LOZANO, Mayra Carmina. Timely rehabilitation: an important adjuvant for management of the critical patient in intensive therapy units. Med. crít. (Col. Mex. Med. Crít.) [online]. 2021, vol.35, n.6, pp.336-341.  Epub 19-Set-2022. ISSN 2448-8909.  https://doi.org/10.35366/103720.

Introduction:

Intensive care units focus primarily on life support and treatment of critically ill patients, but there are many survivors with complications, such as generalized muscle disorders, functional disability, and reduced quality of life after discharge from the hospital, as a result of extended stays in these units. In Mexico, despite the benefits already reported, physiotherapeutic intervention in intensive care units is a strategy that is carried out with very low frequency. The objective of this study was to demonstrate the efficacy of early rehabilitation in an intensive care unit.

Material and methods:

A prospective, observational cohort study with parallel groups, made up of patients admitted to the Intensive Care Unit who received rehabilitation therapy during their stay and a control group, matched by age and sex. The efficacy of the intervention was determined by the improvement identified by means of the modified Rankin scale, evaluated at admission and discharge of the ICU patient.

Results:

A total of 168 individuals were studied, 94 made up the intervention cohort and 74 made up the control group. The average age was 64 years and the groups were balanced by gender. The data obtained in this study demonstrate that the physiotherapeutic intervention intervenes in the recovery of the patient within the ICU, as a protective factor (RR 0.69 CI95% 0.61-0.81) and in the same way it is appreciated that those who did not receive therapy Rehabilitation patients showed greater deterioration in discharge conditions than those who underwent surgery, with differences of up to two points on the Rankin scale (p < 0.001).

Conclusions:

Here we verify that rehabilitation is an excellent option as adjuvant treatment in the patient admitted to the Intensive Care Unit. The decision to use it as a routine procedure could have a positive impact on the quality of life of the patient recovered from a condition that eventually kept his life at risk. We propose the integration of this type of management in clinical practice guidelines, standardized in all intensive care units, giving the opportunity to raise expectations in the care of the critical patient, beyond life support.

Palavras-chave : Rehabilitation in the critical patient; intensive therapy; Rankin scale.

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