Efeitos Da Mobilização Precoce Em Crianças Com Pneumonia Associada a Ventilação Mecânica: Efeitos Sobre Variáveis Não Lineares Da Variabilidade Da Frequência Cardíaca

Abstract

A pesquisa teve como objetivo verificar os efeitos da mobilização precoce em crianças com pneumonia associada à ventilação mecânica (PAV) sobre variáveis não lineares da variabilidade da frequência cardíaca. Foi realizado um ensaio clínico, prospectivo, de caráter quantitativo realizado em 13 pacientes de ambos os gêneros, com idade média de 3±2,3 anos, com diagnóstico de PAV. O estudo foi aprovado pelo Comitê de Ética e Pesquisa da FSCMP, parecer 2.084.580 e registo no Clinical Trials NCT03343717. A análise da recorrência, assim como a DFA ?1, não obtiveram resultados relevantes para o estudo, com p=0,812 e p=0,09, respectivamente. A variável determinismo apresentou resultado com nível de significância

Effectiveness of Different Physiotherapy Protocols in Children in the Intensive Care Unit: A Randomized Clinical Trial

“…Thus, it is possible to infer that children submitted to a physical therapy protocol based on physical exercise, which has one of the benefits of increased HRV, both in the post-protocol and in the follow-up, have less susceptibility to events resulting from poor adaptability, in addition to having the benefit of less time in IMV and less time in the ICU 28. The same results of improvement in HRV were found in a clinical trial in children with pneumonia associated with mechanical ventilation 11…”

“…28 The same results of improvement in HRV were found in a clinical trial in children with pneumonia associated with mechanical ventilation. 11 Other authors have also shown improvements in time on IMV and hospital stay, in addition to functional capacity, increased muscle strength, and decreased late complications 29 in children undergoing early physical exercise. In children, this therapeutic practice is viable and safe, 7 information confirmed by this study since there were no complications such as drops in oxygen saturation or variations in blood pressure that would cause instability to the child.…”

“…Physical therapy based on physical exercise is a strategy used to prevent complications from immobilization, which includes acute muscle weakness, polyneuropathy, and myopathy of critical illness, all attributable to a prolonged stay in bed and affecting between 50% and 80% of children in the ICU 7,8. Physical therapy protocols are safe and viable, and tend to provide improvement in functional capacity, and reduce mortality associated to acute respiratory failure, time on IMV, and hospital stay,9,10 in addition to improving cardiac autonomic modulation 11…”

“…7,8 Physical therapy protocols are safe and viable, and tend to provide improvement in functional capacity, and reduce mortality associated to acute respiratory failure, time on IMV, and hospital stay, 9,10 in addition to improving cardiac autonomic modulation. 11 Heart rate variability (HRV) consists of fluctuation in the intervals between one heartbeat and another, and reflects the regulation of autonomic balance and functions such as maintaining blood pressure and vascular tone. Pathological conditions can produce autonomic cardiac dysregulation, while ideal HRV levels are linked to adaptability.…”

Early mobilization in children with pneumonia in mechanical ventilation: randomized clinical trial

“…Thus, it is noted that the variables corresponding to the parasympathetic response (RMSSD and SD1) and the variables corresponding to the global variability of HR (SD2 and SDNN), showed a statistically significant difference between the CG and EG groups, with higher values in the EG. In this sense, in a recent study (Rocha, Santos, Oliveira, Avila, & Rocha, 2019) on the effects of an exercise protocol in children with VAP, higher values were observed in the non-linear HRV variables in the intervention group, demonstrating that performing this conduct can improve the autonomic modulation of HR.…”