Impacto da polineuromiopatia do paciente crítico no desmame da ventilação mecânica
DOI:
https://doi.org/10.33233/fb.v11i1.1333Abstract
A polineuromiopatia do paciente crítico é uma afecção comum em pacientes graves em unidade de terapia intensiva, expostos a seus fatores de risco, sendo muitas vezes subdiagnosticada e capaz de causar prejuízo funcional ao paciente, incluindo a capacidade ventilatória, desencadeando insufi ciência respiratória aguda por incompetência neuromuscular. A presente revisão, realizada através de pesquisa sistemática da literatura, objetiva identificar se as alterações da contratilidade muscular na polineuromiopatia do paciente crítico, focando na musculatura diafragmática e da parede torácica, podem interferir no desmame do paciente. Desse modo, apresentar-se-ão os aspectos fisiopatológicos da doença, uma breve avaliação física desses aspectos e dados científicos atuais que demonstrem a interferência negativa dessa afecção muscular sobre o desmame da ventilação mecânica. Conclui-se existirem estudos evidentes de que a polineuromiopatia do paciente crítico aumenta o tempo do paciente na ventilação mecânica e atrasa o desmame desta, aumentando o risco de falha na extubação, necessidade de traqueostomia, morbidade e mortalidade associadas í internação hospitalar prolongada. É importante que o fisioterapeuta esteja atento í presença dessa doença, com o objetivo de agir precocemente para minimizar seus efeitos deletérios. Por fim, ressalta-se a necessidade de mais estudos que foquem essa doença como causa de falha no desmame da ventilação mecânica.
Palavras-chave: fisioterapia, miopatias, polineuropatias, desmame do respirador.
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