Transition from acute phase to rehabilitation of the critically ill patient
DOI:
https://doi.org/10.56294/saludcyt2022303Keywords:
Recovery, Complications, Mobilization, ; Mechanical Ventilation, Weaning, Intensive Care UnitAbstract
Introduction: the transition from the acute phase to the rehabilitation of the critically ill patient is guided by the passage from a critical phase to the hemodynamic stabilization of the individual, after ventilatory weaning, use of medication or prolonged stay, although a successful suspension does not guarantee the stability of the patient, because it may present future complications either physical, psychological or social. In addition, a prolonged stay causes the patient to experience abnormalities in his body and poses the risk of adding more than two diseases or disorders after recovery.
Aim: to analyze the complications that occur during the rehabilitation phase of the critically ill patient and to describe strategies to prevent them.
Methods: qualitative research approach, descriptive scope and non-experimental cross-sectional design.
Results: through implementation of exclusion and inclusion criteria, 15 articles were analyzed that provide relevant information about the proposed topic, encompassing the most frequent secondary complications and prevention strategies that can be carried out to favor the patient's rehabilitation.
Conclusions: the rehabilitation of the critically ill patient has complications generated by the long stay, however, approaches are implemented to suppress them, adequate mobilization ensures a prompt recovery and minimizes the consequences of prolonged use, whether mechanical ventilation, immobilization or nutrition
References
1. Bohart S, Møller AM, Andreasen AS, Waldau T, Lamprecht C, Thomsen T. Effect of patient and family centred care interventions for adult intensive care unit patients and their families: a systematic review and meta-analysis. Intensive Crit Care Nurs. 2022;69:103156. doi:10.1016/j.iccn.2021.103156.
2. Bernardes Neto SCG, Torres-Castro R, Lima Í, Resqueti VR, Fregonezi GAF. Weaning from mechanical ventilation in people with neuromuscular disease: a systematic review. BMJ Open. 2021;11(9):e047449. doi:10.1136/bmjopen-2020-047449.
3. Op't Hoog SA, Eskes AM, van Mersbergen-de Bruin MP, Pelgrim T, van der Hoeven H, Vermeulen H, Vloet LC. The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: a systematic review and meta-analysis. Aust Crit Care. 2022;35(3):309-320. doi:10.1016/j.aucc.2021.04.010.
4. Cuzco C, Torres-Castro R, Torralba Y, Manzanares I, Muñoz-Rey P, Romero-García M, Martínez-Momblan MA, Martínez-Estalella G, Delgado-Hito P, Castro P. Nursing interventions for patient empowerment during intensive care unit discharge: a systematic review. Int J Environ Res Public Health. 2021;18(21):11049. doi:10.3390/ijerph182111049.
5. Haruna J, Unoki T, Nagano N, Kamishima S, Kuribara T. Effectiveness of nurse-led interventions for the prevention of mental health issues in patients leaving intensive care: a systematic review. Healthcare (Basel). 2022;10(9):1716. doi:10.3390/healthcare10091716.
6. Ghorbanzadeh K, Ebadi A, Hosseini M, Madah SSB, Khankeh H. Challenges of the patient transition process from the intensive care unit: a qualitative study. Acute Crit Care. 2021 May;36(2):133-142. doi:10.4266/acc.2020.00626.
7. Cuzco C, Delgado-Hito P, Marin-Pérez R, Núñez-Delgado A, Romero-García M, Martínez-Momblan MA, et al. Teoría de las transiciones y empoderamiento: un marco para las intervenciones enfermeras durante la transición del paciente de la unidad de cuidados intensivos. Enferm Intensiva. 2022.
8. Doiron KA, Hoffmann TC, Beller EM. Early intervention (mobilization or active exercise) for critically ill adults in the intensive care unit. Cochrane Database Syst Rev. 2018;3(3):CD010754. doi:10.1002/14651858.CD010754.pub2.
9. Menges D, Seiler B, Tomonaga Y, Schwenkglenks M, Puhan MA, Yebyo HG. Systematic early versus late mobilization or standard early mobilization in mechanically ventilated adult ICU patients: systematic review and meta-analysis. Crit Care. 2021;25(1):16. doi: 10.1186/s13054-020-03446-9. PMID: 33407707; PMCID: PMC7789482.
10. 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. doi: 10.1016/j.jcrc.2018.01.001. Epub 2018 Jan 4. PMID: 29331668.
11. Soto GL. El paciente crítico crónico. Revista Médica Clínica Las Condes. 2019;30(2):160-170.
12. Quisbert E, Molinari N. Destete ventilatorio: revisión sistemática. Salud, Ciencia y Tecnología. 2022;2:91.
13. Catini ME, Faduti A, Chiappero G. Evaluación de la deglución en el paciente internado en Terapia Intensiva: una encuesta nacional. Vol. 37. Argentina; 2020. http://revista.sati.org.ar/index.php.
14. McIntyre M, Chimunda T, Koppa M, Dalton N, Reinders H, Doeltgen S. Risk Factors for Postextubation Dysphagia: A Systematic Review and Meta-analysis. Laryngoscope. 2022;132(2):364-374. doi: 10.1002/lary.29311. Epub 2020 Dec 15. PMID: 33320371.
15. Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020;46(5):888-906. doi: 10.1007/s00134-020-05980-0. Epub 2020 Mar 10. PMID: 32157357; PMCID: PMC7095206.
16. Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Med. 2020 Apr;46(4):637-653. doi: 10.1007/s00134-020-05944-4. Epub 2020 Feb 19. PMID: 32076765; PMCID: PMC7224132.
17. Olmos M, Varela D, Klein F. Enfoque actual de la analgesia, sedación y el delirium en cuidados críticos. Revista Médica Clínica Las Condes. 2019;30(2):126-139.
18. Qie XJ, Liu ZH, Guo LM. Evaluation of progressive early rehabilitation training mode in intensive care unit patients with mechanical ventilation. World J Clin Cases 2022;10(23):8152-8160 PMID: 36159546 DOI: 10.12998/wjcc.v10.i23.
19. Güler EK, Türk G. Oral Chlorhexidine Against Ventilator-Associated Pneumonia and Microbial Colonization in Intensive Care Patients. West J Nurs Res. 2019 Jun;41(6):901-919. doi: 10.1177/0193945918781531. Epub 2018 Jun 15. PMID: 29907077.
20. Moreira E, Olano E, Manzanares W. Terapia nutricional en el paciente crítico con COVID-19. Revista Médica Uruguay. 2020;36(1).
21. Zhang L, Hu W, Cai Z, Liu J, Wu J, Deng Y, Yu K, Chen X, Zhu L, Ma J, Qin Y. Early mobilization of critically ill patients in the intensive care unit: A systematic review and meta-analysis. PLoS One. 2019;14(10):e0223185. doi: 10.1371/journal.pone.0223185. PMID: 31581205; PMCID: PMC6776357.
22. Cardós RH, Olivar DP, Tejero MP, Pasamón RY, Abolafia LM, Torrecilla SB. Movilización temprana de pacientes en unidades de cuidados intensivos: Revisión bibliográfica. Revista Sanitaria de Investigación. 2021;2(8):69.
23. Garegnania LI. Movilización precoz en pacientes con ventilación mecánica. Scielo. 2018;18(1):33–41.
24. Carmona-Espejo A, González-Villén R. Terapia rehabilitadora en unidades de cuidados intensivos. Revisión sistemática. Retos. 2022; 46:758–66.
Published
Issue
Section
License
Copyright (c) 2022 Verónica Sofia Quenorán Almeida , María Eugenia Bonilla Sánchez , Nieves Liseth Cañaveral Estrella , Eveline Prissila López Solis , Lizeth Estefanía Navas Fonseca , Brenda Brigitte Pombosa Bravo (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.