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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2020.tde-12022020-121015
Document
Author
Full name
Thais Borgheti de Figueiredo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2019
Supervisor
Committee
Tanaka, Clarice (President)
Chiavegato, Luciana Dias
Fu, Carolina
Park, Marcelo
Title in Portuguese
Caracterização da unidade de terapia intensiva dos queimados do Hospital das Clínicas de São Paulo sob a perspectiva fisioterapêutica
Keywords in Portuguese
Desempenho funcional
Limitação da mobilidade
Mobilização precoce
Modalidades de fisioterapia
Unidades de queimados
Unidades de terapia intensiva
Abstract in Portuguese
Introdução: Pacientes com queimaduras geralmente requerem hospitalização prolongada parcialmente devido ao tratamento de feridas e cicatrizes. Embora os benefícios da mobilização precoce sejam bem conhecidos em pacientes em terapia intensiva, faltam estudos relatando práticas de mobilização e status funcional para pacientes com queimaduras. Métodos: Os dados clínicos e de fisioterapia foram coletados diariamente, incluindo a Escala de Mobilidade na UTI (EMU) e as barreiras relatadas à fisioterapia motora durante o período de um ano. Na alta hospitalar, o teste de caminhada de 6 minutos (TC6M), a escala Medical Research Council (MRCS) e o teste de força de preensão manual foram aplicados para avaliar a funcionalidade dos pacientes. Resultados: Dos 74 pacientes admitidos, 66% foram submetidos à ventilação mecânica (VM). A fisioterapia motora foi realizada em 67,2% das sessões de fisioterapia, sendo a mobilização passiva a mais prevalente (53,2%), seguida de exercícios ativos no leito (13,6%). As barreiras relatadas para mobilização incluíram instabilidade hemodinâmica seguida de tempo limitado para assistência. Na alta hospitalar, a distância percorrida no TC6M era de 270 (136) metros. Foi encontrada uma correlação positiva entre a avaliação da força de preensão manual e o TC6M e uma correlação negativa com o tempo de internação hospitalar. Conclusão: A fisioterapia motora em pacientes com queimaduras na UTI foi caracterizada por um baixo nível de mobilidade durante a VM com um baixo status funcional na alta hospitalar
Title in English
Characterization of the intensive care unit of burns of the Hospital das Clínicas of São Paulo from the physiotherapeutic perspective
Keywords in English
Burn units
Early mobilization
Functional performance
Intensive care units
Mobility limitation
Physical therapy modalities
Abstract in English
Purpose: Patients with burn usually require prolonged hospitalization due partially to the treatment of wounds and scars. Although the benefits of early mobilization are well-known in critical care patients, there are a lack of studies reporting mobilization practices and functional status for patients with burn. Materials: Clinical and physiotherapy data were daily collected, including ICU mobility scale (IMS) and reported barriers to mobilization therapy during a one-year period. At hospital discharge, the 6-minute walking test (6MWT), Medical Research Council scale (MRCS) and handgrip strength test were applied to evaluate the patients' functionality. Results: Of the 74 patients admitted, 66% were placed on mechanical ventilation (MV). Mobilization therapy was administered in 67.2% of physiotherapy sessions, with passive mobilization being the most prevalent (53.2%) followed by active in-bed exercises (13.6%). Reported barriers for mobilization included hemodynamic instability followed by limited time for assistance. At hospital discharge, the 6MWD was 270(136) meters. A positive correlation was found between handgrip evaluation and 6MWD and a negative correlation with hospital length of stay. Conclusions: Mobilization therapy of patients with burns in the ICU was characterized by a low mobility level during MV with a low functional status at hospital discharge.
 
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Publishing Date
2020-02-12
 
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