Disorders of myoneural junction and muscle in diseases classified elsewhere/comatose patient.
Conditions
Interventions
Control group (passive mobilization): 40 patients within 48 hours of admission to the intensive care unit and at least seven days in a coma (40 experimental units or lower limbs) will receive passive
Martec, Ribeirão Preto, Brazil) will be positioned over the posterior tibial artery to determine total vascular occlusion pressure from cuff insufflation to auscultatory pulse interruption. An externa
Other
G11.427.410.698.277
E02.331.800
Sponsors
Centro de Ciências Biológicas e da Saúde da Universidade Federal de São Carlos
Programa de Pós-graduação em Fisioterapia da Universidade Federal de São Carlos
Departamento de Fisioterapia da Universidade Federal de São Carlos
Eligibility
Age
18 Years to 60 Years
Inclusion criteria
Inclusion criteria: Forty comatose patients admitted to the Adult Intensive Care Unit (ICU) of Santa Casa de Misericórdia de São Carlos will be included in the study. Inclusion criteria will be individuals aged 18 to 60 years (BARBALHO et al., 2018; DIRKS et al., 2015); Ramsay sedation scale with a score of 6 to 4 (DE JONGHE et al., 2000) or a score of 3 to 6 on the Glasgow coma scale (REITH et al., 2016) and with daily protein intake standardized by ICU medical and nutrition team (BARBALHO et al., 2018).
Exclusion criteria
Exclusion criteria: Obese patients (body mass index greater than 30 kg / m²); with more than one risk factor for venous thromboembolism (ANDERSON; SPENCER, 2003); using vasoactive drugs; fever; anemia; thrombocytopenia and neurodegenerative and musculoskeletal diseases will not be included in the research. Persistent arrhythmias such as atrial fibrillation; pre-existing atrioventricular block or ventricular tachycardia; recent acute myocardial infarction; provisional or definitive pacemaker; signs of intracranial hypertension; neoplasia under chemotherapy treatment and unconsolidated fracture will be considered criteria for non-inclusion in the study (GEROVASILI et al., 2009).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Prevention of muscle atrophy is expected through the method of ultrasound imaging evaluation of the vastus lateralis, rectus femoris and anterior tibialis muscle from the finding of no reduction in muscle thickness and quality. | — |
Secondary
| Measure | Time frame |
|---|---|
| Prevention of worsening severity and morbidity and mortality is expected by applying the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and length of stay (hours / day), mechanical ventilation time (hours / day). day), number of failures and percentage of mortality occurred from the finding of no increase in severity, percentage of predicted and occurred mortality, length of stay and mechanical ventilation and number of failures to ventilatory weaning.;It is expected to find safe cardiovascular physiological changes assessed by transthoracic electrical bioimpedance from the finding of physiological changes within normal heart rate, stroke volume, cardiac output and cardiac index.;It is expected to find hemodynamic safe physiological changes assessed by pulse wave analysis from the finding of physiological changes within normal central and peripheral systolic and diastolic pressures.;It is expected to find the prevention of muscle weakness through the electrodiagnostics test of stimulation of the vastus lateralis and rectus femoris muscle from the finding of no occurrence of neuromuscular electrophysiological disorders (chronaxis greater than or equal to 1000 microseconds). | — |
Countries
Brazil
Contacts
Public ContactThaís Pires de Campos Biazon
Pós-graduação em Fisioterapia da Universidade Federal de São Carlos
Outcome results
None listed