Mobilização de pós-cirurgia cardíaca com dreno de mediastino e torácico
Mobilização de pós-cirurgia cardíaca com dreno de mediastino e torácico
Data
2023
Autores
Perrot, Alexandra de Lima
Silva, Fellipe Allevato Martins da
Journal Title
Journal ISSN
Volume Title
Publisher
Revista FT
Resumo
INTRODUÇÃO: As doenças cardiovasculares são a causa número um de mortes no Brasil e no mundo, segundo a Sociedade Brasileira de Cardiologia (SBC) em 2022, consequentemente o número de cirurgias cardíacas realizadas anualmente possui um valor expressivo. Nos casos pós-cirúrgicos que apresentam derrame pericárdico ocorre um acúmulo de líquido que pode levar ao tamponamento cardíaco. Visando reduzir estes riscos, são introduzidos drenos torácicos, mediastinal e pleural ao final da cirurgia, para realizar a função de drenagem deste líquido. Os pacientes em utilização de dreno de tórax ficam mais restritos ao leito por inúmeros motivos, gerando importantes comorbidades. O papel do fisioterapeuta é primordial para auxiliar na mobilização desses doentes para reduzir os efeitos das comorbidades associadas ao tempo de permanência no leito, como redução da força muscular, atrofias, aumento do risco de trombose venosa profunda, atelectasias, maior tempo de internação, aumento do risco de infecções, morbidade e até mesmo mortalidade. OBJETIVOS: O objetivo deste estudo tem por finalidade avaliar os benefícios da mobilização do paciente pós-cirurgia cardíaca com dreno de mediastino e/ou torácico. METODOLOGIA: Revisão bibliográfica sistematizada, de caráter exploratório, que foi realizada baseada no levantamento de dados encontrados em plataformas online como LILACS, MEDLINE, SCIELO, PUBMED. RESULTADOS: Tabela1. Resultados encontrados após análise dos dados encontrados nos artigos. DISCUSSÃO: Houve estudos que evidenciam a eficácia da fisioterapia respiratória associada a mobilização do paciente com ou sem auxílio de ventilação não invasiva na recuperação do paciente em pós-operatório de cirurgia cardíaca com dreno de tórax. Também foi demonstrado que o posicionamento do dreno influencia na melhora dos parâmetros ventilatórios, níveis de dor e oxigenação do paciente. A retirada do leito até 48 horas após a abordagem demonstrou efeitos positivos. CONCLUSÃO: Pode-se concluir que a mobilização do paciente pós-cirurgia cardíaca com dreno torácico contribui para uma recuperação mais breve e com menores riscos de comorbidades associadas. São necessários mais estudos sobre o tema para permitir uma análise mais assertiva e eficaz.
INTRODUCTION: Cardiovascular diseases are the number one cause of death in Brazil and in the world, according to the Brazilian Society of Cardiology (SBC) in 2022, consequently the number of cardiac surgeries performed annually has a significant value. In post-surgical cases that present pericardial effusion, there is an accumulation of fluid that can lead to cardiac tamponade. In order to reduce these risks, thoracic, mediastinal or pleural drains are introduced at the end of the surgery, in order to drain this liquid. Patients using a chest drain are more confined to bed for several reasons, generating important comorbidities. The role of the physiotherapist is paramount in assisting in the mobilization of these patients to reduce the effects of comorbidities associated with the length of stay in bed, such as reduced muscle strength, atrophies, increased risk of deep venous thrombosis, atelectasis, longer hospital stay, increased the risk of infections, morbidity and even mortality. OBJECTIVES: The objective of this study is to evaluate the benefits of patient mobilization after cardiac surgery with mediastinal and/or thoracic drain. METHODOLOGY: Systematized bibliographic review, of an exploratory nature, which was carried out based on the survey of data found in online platforms such as LILACS, MEDLINE, SCIELO and PUBMED. RESULTS: Table 1. Results found after analyzing the articles data. DISCUSSION: There were studies that proved the effectiveness of respiratory physiotherapy associated with patient mobilization with or without non-invasive ventilation in the recovery of patients in the postoperative period of cardiac surgery with chest tube. It was also evidenced that the positioning of the drain influences the improvement of ventilatory parameters, pain levels and patient oxygenation. Removing patient of the bed within 48 hours after the approach showed significant effects. CONCLUSION: It can be concluded that patient mobilization after cardiac surgery with a chest tube contributes to a shorter recovery and lower risk of associated comorbidities. More studies on the subject are needed to allow a more assertive and effective analysis.
INTRODUCTION: Cardiovascular diseases are the number one cause of death in Brazil and in the world, according to the Brazilian Society of Cardiology (SBC) in 2022, consequently the number of cardiac surgeries performed annually has a significant value. In post-surgical cases that present pericardial effusion, there is an accumulation of fluid that can lead to cardiac tamponade. In order to reduce these risks, thoracic, mediastinal or pleural drains are introduced at the end of the surgery, in order to drain this liquid. Patients using a chest drain are more confined to bed for several reasons, generating important comorbidities. The role of the physiotherapist is paramount in assisting in the mobilization of these patients to reduce the effects of comorbidities associated with the length of stay in bed, such as reduced muscle strength, atrophies, increased risk of deep venous thrombosis, atelectasis, longer hospital stay, increased the risk of infections, morbidity and even mortality. OBJECTIVES: The objective of this study is to evaluate the benefits of patient mobilization after cardiac surgery with mediastinal and/or thoracic drain. METHODOLOGY: Systematized bibliographic review, of an exploratory nature, which was carried out based on the survey of data found in online platforms such as LILACS, MEDLINE, SCIELO and PUBMED. RESULTS: Table 1. Results found after analyzing the articles data. DISCUSSION: There were studies that proved the effectiveness of respiratory physiotherapy associated with patient mobilization with or without non-invasive ventilation in the recovery of patients in the postoperative period of cardiac surgery with chest tube. It was also evidenced that the positioning of the drain influences the improvement of ventilatory parameters, pain levels and patient oxygenation. Removing patient of the bed within 48 hours after the approach showed significant effects. CONCLUSION: It can be concluded that patient mobilization after cardiac surgery with a chest tube contributes to a shorter recovery and lower risk of associated comorbidities. More studies on the subject are needed to allow a more assertive and effective analysis.
Description
Palavras-chave
Physiotherapy mobilization, Postoperative physiotherapy, Cardiac rehabilitation, Mediastinal drain, Cardiac surgery, Mobilização fisioterapêutica, Fisioterapia pós-operatória, Reabilitação cardíaca, Dreno mediastinal, Cirurgia cardíaca
Citação
Perrot AL, Silva FAM. Mobilização e pós-cirurgia cardíaca com dreno de mediastino e torácico. Revista FT. 2023;123(27):1-22. Doi: 10.5281/zenodo.8071819.