Nursing knowledge to prevent muscle weakness in mechanically ventilated patients
DOI:
https://doi.org/10.35381/s.v.v10i2.5109Keywords:
Muscle weakness, mechanical ventilation, early mobilization, nursing care, intensive care unit, (Source: DeCS).Abstract
Muscle weakness associated with mechanical ventilation is a common complication that prolongs ICU stays and affects functional recovery. Objective: To analyze nursing knowledge to prevent muscle weakness in mechanically ventilated patients. Method: Qualitative, descriptive, and non-experimental literature review based on 42 studies published between 2017 and 2022, selected from Google Scholar, PubMed, Scielo, Scopus, and Latindex, through analysis and documentary synthesis. Results: The literature identifies multifactorial etiology (immobility, sepsis, prolonged ventilation, use of sedatives and corticosteroids), risk factors such as age, hyperglycemia, and malnutrition, and complications such as myopathies, polyneuropathies, and diaphragmatic dysfunction. Barriers to early mobility are evident, including a lack of trained personnel and the absence of protocols. Conclusions: Nursing knowledge is essential for implementing early mobilization, preventing complications, and reducing muscle weakness, highlighting the need for protocols and multidisciplinary work.
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Mejía AAC, Martínez NGM, Nieto ORP, Camacho M Ángel M, Tomas ED, Martínez BP. Movilización Temprana Como Prevención Y Tratamiento Para La Debilidad Adquirida En La Unidad De Cuidados Intensivos En Pacientes En Ventilación Mecánica. Experiencia En Un Hospital De Segundo Nivel. ESJ. 2018;14(21):19. https://doi.org/10.19044/esj.2018.v14n21p19
Vicente A, Amoza RL, García Reid C, Tocalini P, Prieto L, Savio P, Simioni MB, Ferrario A, Cura AJ, Tozzi WA, Villarruel M, Verde GA, Garegnani LI, Virgilio SA. Características epidemiológicas y factores de riesgo de los pacientes adultos con Debilidad Adquirida en la Unidad de Cuidados Intensivos. Rev. am. med. respir. 2020;20(3):215-224. https://n9.cl/oiovx6
Plascencia-Zurita LA, Manzano-Vergara A. Movilización temprana pasiva en pacientes con ventilación mecánica. Med Int Méx. 2019;35(6):944-951. https://doi.org/10.24245/mim.v35i6.2662
Das B, Saha S, Kabir F, Hossain S. Effect of Graded Early Mobilization on Psychomotor Status and Length of Intensive Care Unit Stay in Mechanically Ventilated Patients. Indian J Crit Care Med. 2021;25(4):416-420. https://doi.org/10.5005/jp-journals-10071-23789
Ballve LPD, Dargains N, Inchaustegui JGU, Bratos A, Percaz MM, Ardariz CB, Cagide S, Balestrieri C, Gamarra C, Paz D, Rotela E, Muller S, Bustos F, Aranda Castro R. Settembrino E. Debilidad adquirida en la unidad de cuidados intensivos. Incidencia, factores de riesgo y su asociación con la debilidad inspiratoria. Estudio de cohorte observacional. Rev Bras Ter Intensiva. 2017;29(4):466-75. https://doi.org/10.5935/0103-507X.20170063
Raurell-Torredà M, Arias-Rivera S, Martí JD, Frade-Mera MJ, Zaragoza-García I, Gallart E, Velasco-Sanz TR, San José-Arribas A, Blázquez-Martínez E; Grupo MOviPre. Degree of implementation of preventive strategies for post-ICU syndrome: Multi-centre, observational study in Spain. Enferm Intensiva (Engl Ed). 2019;30(2):59-71. https://doi.org/10.1016/j.enfi.2018.04.004
Babazadeh M, Jahani S, Poursangbor T, Cheraghian B. Perceived barriers to early mobilization of intensive care unit patients by nurses in hospitals affiliated to Jundishapur University of Medical Sciences of Ahvaz in 2019. J Med Life. 2021;14(1):100-104. https://doi.org/10.25122/jml-2019-0135
Arévalo Tabares AY, Cruz Mosquera FE, Valencia Salazar YV, Peláez Domínguez DA, Rosero Portocarrero JD. Conocimientos, percepciones y prácticas en profesionales de la salud sobre movilizacion temprana en los pacientes de las unidades de cuidados intensivos. Enferm. investig. 2021;6(2):5-11. https://n9.cl/io2yx
Rivo Sayoux BN, Reynosa Aguilar Y, Cantillo Ferreiro E, Fernández Llombar JO. La rehabilitación temprana del paciente grave. Rev Cuba Información Cient (RIC), 2019;98(25):673-685. https://n9.cl/czdbm
Martínez Camacho MÁ, Jones Baro RA, Gómez González A, Pérez Nieto OR, Guerrero Gutiérrez MA, Zamarrón López EI, Soriano Orozco R, Deloya Tomas E, Sánchez Díaz JS, Morgado Villaseñor LA. Movilización temprana en la Unidad de Cuidados Intensivos. Med. crít. (Col. Mex. Med. Crít.). 2021;35(2):89-95. https://doi.org/10.35366/99529
Sosa A, Pérez Díaz F, Melgarejo F, Ramírez A, Amedey M, Bianchini F, Di Salvo E, Domínguez Royano R, Brozzi I, Del Bono M. Debilidad adquirida en la Unidad de Cuidados Intensivos. Fronteras en Medicina. 2019;(02):0094-0097. https://doi.org/10.31954/RFEM/201902/0094-0097
Damiani LF, Yourchua J, Dubo S. Disfunción Diafragmática en Ventilación Mecánica: Evaluación e Implicancias Clínicas. Kinesiologia. 2020;39(2):89-99. https://n9.cl/8fqo5
Dong Z, Saha S, Kabir F, Hossain S. Early rehabilitation relieves diaphragm dysfunction induced by prolonged mechanical ventilation: a randomised control study Indian J Crit Care Med. 2021;25(4):416-420. https://doi.org/10.1186/s12890-021-01461-2
Taylor C. Intensive care unit acquired weakness. Anaesthesia and Intensive Care Medicine 2021;22:81-84. https://doi.org/10.1016/j.mpaic.2020.12.006
Piva S, Fagoni N and Latronico N. Intensive care unit–acquired weakness: unanswered questions and targets for future research. F1000Research. 2019;8(F1000 Faculty Rev):508 https://doi.org/10.12688/f1000research.17376.1
Owen AM, Patel SP, Smith JD, Balasuriya BK, Mori SF, Hawk GS, Stromberg AJ, Kuriyama N, Kaneki M, Rabchevsky AG, Butterfield TA, Esser KA, Peterson CA, Starr ME, Saito H. Chronic muscle weakness and mitochondrial dysfunction in the absence of sustained atrophy in a preclinical sepsis model. Elife. 2019;8:e49920. https://doi.org/10.7554/eLife.49920
Cheung K, Rathbone A, Melanson M, Trier J, Ritsma BR, Allen MD. Pathophysiology and management of critical illness polyneuropathy and myopathy. J Appl Physiol (1985). 2021;130(5):479-1489. https://doi.org/10.1152/japplphysiol.00019.2021
Carmona-Espejo A, González-Villén R. RETRACT THE ARTICLE. BAD PRACTICES, Terapia rehabilitadora en unidades de cuidados intensivos. Revision sistemática. Retos. 2022;46:758-766. https://doi.org/10.47197/retos.v46.94086
Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Med. 2020;46:637-653. https://doi.org/10.1007/s00134-020-05944-4
Hill A, Elke G, Weimann A. Nutrition in the Intensive Care Unit-A Narrative Review. Nutrients. 2021;13(8):2851. https://doi.org/10.3390/nu13082851
Zamora-Elson M, Martínez-Carmona JF, Ruiz-Santana S. Recommendations for specialized nutritional-metabolic management of the critical patient: Consequences of malnutrition in the critically ill and assessment of nutritional status. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC). Med Intensiva (Engl Ed). 2020;44(Suppl 1):19-23. https://doi.org/10.1016/j.medin.2020.01.007
Smith S, Rahman O. Postintensive Care Syndrome. 2023. En: StatPearls. Treasure Island (FL): StatPearls Publishing; 2026. https://n9.cl/b6uip
Martínez-Leiva J, Parra-Montañez G, Segura-Esquivel J. Acciones y beneficios que proporciona la intervención del Terapeuta Ocupacional en la Unidad de Cuidados Intensivos de adultos. Rev Ter. 2020;14(1):11-23. https://doi.org/10.33967/rt.v14i1.94
Vollenweider R, Manettas AI, Häni N, de Bruin ED, Knols RH. Passive motion of the lower extremities in sedated and ventilated patients in the ICU - a systematic review of early effects and replicability of Interventions. PLoS One. 2022;17(5):e0267255. https://doi.org/10.1371/journal.pone.0267255
Jarrín Anchundia PS. Movilización precoz del paciente en Cuidados Intensivos. Acta méd. Grupo Ángeles. 2022;20(3):255-257. https://doi.org/10.35366/105729
Fossat G, Baudin F, Courtes L, Bobet S, Dupont A, Bretagnol A, Benzekri-Lefèvre D, Kamel T, Muller G, Bercault N, Barbier F, Runge I, Nay MA, Skarzynski M, Mathonnet A, Boulain T. Effect of In-Bed Leg Cycling and Electrical Stimulation of the Quadriceps on Global Muscle Strength in Critically Ill Adults: A Randomized Clinical Trial. JAMA. 2018;320(4):368-378. https://doi.org/10.1001/jama.2018.9592
Timenetsky KT, Neto AS, Assunção MSC, Taniguchi L, Eid RAC, Corrêa TD. () Mobilization practices in the ICU: A nationwide 1-day point- prevalence study in Brazil. PLoS ONE. 2020;15(4):e0230971. https://doi.org/10.1371/journal.pone.0230971
Mankowski RT, Laitano O, Clanton TL, Brakenridge SC. Pathophysiology and Treatment Strategies of Acute Myopathy and Muscle Wasting after Sepsis. J Clin Med. 2021;10(9):1874. https://doi.org/10.3390/jcm10091874
Cordero Cabrera M, Hernández Yut S, Rodríguez Mazó YC, Morales Reyes D, Aguado Valdés S. Estrategias de intervención comunitaria en salud. En: XVIII Congreso de la Sociedad Cubana de Enfermería 2019, nov 25 29; La Habana, Cuba. La Habana: Sociedad Cubana de Enfermería; 2019. https://n9.cl/78mxdr
Bazualdo Fiorini ER, Mariño Bayas AM, Castillo Chico GE, Chiriboga Calva MI. Manejo quirúrgico de las ulceras por presión. RECIAMUC. 2021;5(1):282-298. https://doi.org/10.26820/reciamuc/5.(1).ene.2021.282-298
Pang Y, Li H, Zhao L, Zhang C. An Established Early Rehabilitation Therapy Demonstrating Higher Efficacy and Safety for Care of Intensive Care Unit Patients. Med Sci Monit. 2019;25:7052-7058. https://doi.org/10.12659/MSM.916210
Wright SE, Thomas K, Watson G, Baker C, Bryant A, Chadwick TJ, Shen J, Wood R, Wilkinson J, Mansfield L, Stafford V, Wade C, Furneval J, Henderson A, Hugill K, Howard P, Roy A, Bonner S, Baudouin S. Intensive versus standard physical rehabilitation therapy in the critically ill (EPICC): a multicentre, parallel-group, randomised controlled trial. Thorax. 2018;73(3):213-221. https://doi.org/10.1136/thoraxjnl-2016-209858
Wang XL, Ma LJ, Hu XG, Wang K, Cheng JJ. Application of the respiratory "critical care-sub-critical care-rehabilitation integrated management model" in severe stroke associated pneumonia. BMC Pulm Med. 2020;20(1):61. https://doi.org/10.1186/s12890-020-1100-7
McWilliams D, Jones C, Atkins G, Hodson J, Whitehouse T, Veenith T, Reeves E, Cooper L, Snelson C. Earlier and enhanced rehabilitation of mechanically ventilated patients in critical care: A feasibility randomised controlled trial. J Crit Care. 2018;44:407-412. https://doi.org/10.1016/j.jcrc.2018.01.001
Koutsioumpa E, Makris D, Theochari A, Bagka D, Stathakis S, Manoulakas E, Sgantzos M, Zakynthinos E. Effect of Transcutaneous Electrical Neuromuscular Stimulation on Myopathy in Intensive Care Patients. Am J Crit Care. 2018;27(6):495-503. https://doi.org/10.4037/ajcc2018311
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