Mobilization strategies in minimizing pressure injuries in patients in the hospital setting

Authors

DOI:

https://doi.org/10.33448/rsd-v11i9.32173

Keywords:

Pressure ulcer; Early ambulation; Pronation.

Abstract

Objective: Need for knowledge about the mobilization strategies used to minimize the emergence of pressure injuries in patients confined to the hospital bed. Method: this study is a systematic review, in which eligibility criteria based on the PICO strategy were used, which included randomized clinical trials, which contained titles that addressed "pressure injuries" and/or "mobilization" Results: The selection process identified 1076 studies. After full reading and exclusion of duplicates and screening abstracts, 229 studies were selected. Among these, 15 scientific articles met the inclusion criteria. All studies pointed to pressure injuries as complication or adverse effect related to immobilization and prolonged hospitalization. Conclusion: Evidence shows that early mobilization is a safe technique with positive short and long-term results. in the ICU.

References

Alencar, G. S. A., Silva, N. M., Assis, E. V., Sousa, M. N. A., Pereira, J. L. F., Oliveira, W. B. et al. (2018). Injury in the therapy unit intensive care: incidence and risk factors. Nursing. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-907895.

Aquim, E. E., Bernardo, W. M., Buzzini, R. F., Azeredo, N. S. G., Cunha, L. S., Damasceno, M. C. P. et al. (2019). Brazilian Guidelines for Early Mobilization in Intensive Care Unit. Rev Bras Ter Intensiva. 31(4):434-443. https://doi.org/10.5935/0103-507X.20190084.

Araujo, M. T., Castanheira, L. S., Guimarães, M. C. S. e S., & Silva, Y. O. de W. (2019). Análise de custo da prevenção e do tratamento de lesão por pressão: revisão sistemática: Cost analysis of pressure injury prevention and treatment: systematic review. Revista Enfermagem Atual In Derme, 89(27). https://doi.org/10.31011/reaid-2019-v.89-n.27-art.47

Beuret, P., Carton, M. J., Nourdine, K., Kaaki, M., Tramoni, G., & Ducreux, J. C. (2002). Prone position as prevention of lung injury in comatose patients: a prospective, randomized, controlled study. Intensive Care Med; 28(5):564-569. http://doi.org/10.1007/s00134-002-1266-x

Busanello, J., Pinto, D. M., Schons, E. S., Baumgart, D., & Poll, M. A. (2015). Cuidados de enfermagem ao paciente adulto: prevenção de lesões cutaneomucosas e segurança do paciente. Revista De Enfermagem Da UFSM; 5(4), 597–606. https://doi.org/10.5902/2179769216310.

Choong, K., Awladthani, S., Khawaji, A., et al. (2017). Early Exercise in Critically Ill Youth and Children, a Preliminary Evaluation: The wEECYCLE Pilot Trial. Pediatr Crit Care Med; 18(11):e546-e554. https://doi.org/10.1097/PCC.0000000000001329.

Cochrane Training (2020). Cochrane RevMan. London: The Cochrane Collaboration;https://training.cochrane.org/online-learning/core-software-cochrane-reviews/revman

Conceição, T. M. A., Gonzáles, A. I., Figueiredo, F. C. X. S., Vieira, D. S. R., & Bündchen, D. C. (2017). Safety criteria to start early mobilization in intensive care units. Systematic review. Rev Bras Ter Intensiva; 29(4): 509-519. https://doi.org/10.5935/0103-507X.20170076.

Connolly, B., O'Neill, B., Salisbury, L., & Blackwood, B.; (2016). Enhanced Recovery After Critical Illness Programme Group. Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews. Thorax; 71(10):881-890. https://doi.org/10.1136/thoraxjnl-2015-208273.

Costa, F. M., Correa, A. D. B., Neto, E. N., Vieira, E. M. M., Nasrala, M. L. S., Lima, E., et al. (2014). Avaliação da Funcionalidade Motora em Pacientes com Tempo Prolongado de Internação Hospitalar. UNOPAR Cient Ciênc Biol Saúde. https://doi.org/10.17921/2447-8938.2014v16n2p%25p

Cunha, C. V., Ferreira, D., Nascimento, D., Felix, F., Cunha, P., & Penna, L. H. G. (2016). Artigo de Revisão - Dermatite associada à incontinência em idosos: caracterização, prevenção e tratamento. ESTIMA. https://www.revistaestima.com.br/estima/article/view/218

Curley, M. A., Hibberd, P. L., Fineman, L. D., Wypij, D., Shih, M. C., Thompson, J. E., Grant, M. J., Barr, F. E., Cvijanovich, N. Z., Sorce, L., Luckett, P. M., Matthay, M. A., & Arnold, J. H. (2005). Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial. JAMA; 294(2), 229‐237. https://doi.org/10.1001/jama.294.2.229

Davidson, J. E., Harvey, M. A., Bemis-Dougherty, A., Smith, J. M., & Hopkins, R. O. (2013). Implementation of the Pain, Agitation, and Delirium Clinical Practice Guidelines and promoting patient mobility to prevent post-intensive care syndrome. Crit Care Med; 41(9 Suppl 1):S136-S145. https://doi.org/10.1097/CCM.0b013e3182a24105

Diserens, K., Moreira, T., Hirt, L., et al. (2012). Early mobilization out of bed after ischaemic stroke reduces severe complications but not cerebral blood flow: a randomized controlled pilot trial. Clin Rehabil. https://doi.org/10.1177/0269215511425541

Fernandez, R., Trenchs, X., Klamburg, J., et al. (2008). Prone positioning in acute respiratory distress syndrome: a multicenter randomized clinical trial. Intensive Care Med; 34(8):1487-1491. https://doi.org/10.1007/s00134-008-1119-3

Fineman, L. D., LaBrecque, M. A., Shih, M. C., & Curley, M. A. (2006). Prone positioning can be safely performed in critically ill infants and children. Pediatr Crit Care Med. https://doi.org/10.1097/01.PCC.0000235263.86365.B3

Gattinoni, L., Tognoni, G., Pesenti, A., et al. (2001). Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med; 345(8):568-573. https://doi.org/10.1056/NEJMoa010043

Girard, R., Baboi, L., Ayzac, L., Richard, J. C., & Guérin, C. (2014). Proseva trial group. The impact of patient positioning on pressure ulcers in patients with severe ARDS: results from a multicentre randomised controlled trial on prone positioning. Intensive Care Med; 40(3):397-403. https://doi.org/10.1007/s00134-013-3188-1

Guérin, C., Reignier, J., Richard, J. C., et al. (2013). Prone positioning in severe acute respiratory distress syndrome. N Engl J Med; 368(23):2159-2168. https://doi.org/10.1056/NEJMoa1214103

Hofman, A., Geelkerken, R. H., Wille, J., Hamming, J. J., Hermans, J., & Breslau, P. J. (1994). Pressure sores and pressure-decreasing mattresses: controlled clinical trial. Lancet; 343(8897):568-571. https://doi.org/10.1016/s0140-6736(94)91521-0

Inman, K. J., Sibbald, W. J., Rutledge, F. S., & Clark, B. J. (1993). Clinical utility and cost-effectiveness of an air suspension bed in the prevention of pressure ulcers. JAMA, 269(9), 1139–1143.

Kayambu, G., Boots, R., & Paratz, J. (2013). Fisioterapia para pacientes críticos na UTI: revisão sistemática e metanálise. Medicina de cuidados intensivos, 41(6)1543-1554. https://doi.org/10.1097/CCM.0b013e31827ca637

Mancebo, J., Fernández, R., Blanch, L., Rialp, G., Gordo, F., Ferrer, M., Rodríguez, F., Garro, P., Ricart, P., Vallverdú, I., Gich, I., Castaño, J., Saura, P., Domínguez, G., Bonet, A., & Albert, R. K. (2006). A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome. American journal of respiratory and critical care medicine, 173(11), 1233–1239. https://doi.org/10.1164/rccm.200503-353OC

McHugh, M. L. (2012). Lessons in biostatistics interrater reliability: the kappa statistic. Biochem Medical. https://hrcak.srce.hr/89395

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med; 6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.

Mota, C. M., & Silva, V. G. da. (2012). A segurança da mobilização precoce em pacientes críticos: uma revisão de literatura. Interfaces Científicas - Saúde E Ambiente, 1(1), 83–91. https://doi.org/10.17564/2316-3798.2012v1n1p83-91

National Pressure Injury Advisory Panel (2012). Úlceras de Pressão: Prevalência, Incidência e Implicações do Futuro. NPIAP. https://npiap.com/store/ViewProduct.aspx?id=14091387

Neto, J. M. R., Viana, R. A. P. P., Franco, A. S., Prado, P. R., Gonçalves, F. A. F., & Nóbrega, M. M. L. (2020). Nursing Diagnosis/Outcomes and Interventions for Critically Ill Patients affected by COVID-19 and Sepsis. Texto & Contexto Enfermagem; 29:e20200160. doi: https://doi.org/10.1590/1980-265X-TCE-2020-0160.

Otto, C., Schumacher, B., Wiese, L., Ferro, C., & Rodrigues, R. (2019). Fatores de risco para o desenvolvimento de lesão por pressão em pacientes críticos. Enfermagem em Foco, 10(1). https://doi.org/10.21675/2357-707X.2019.v10.n1.1323

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372, n71. https://doi.org/10.1136/bmj.n71

Pandullo, S. M., Spilman, S. K., Smith, J. A., Kingery, L. K., Pille, S. M., Rondinelli, R. D., & Sahr, S. M. (2015). Time for critically ill patients to regain mobility after early mobilization in the intensive care unit and transition to a general inpatient floor. Journal of critical care, 30(6), 1238–1242. https://doi.org/10.1016/j.jcrc.2015.08.007

Piva, T. C., Ferrari, R. S., & Schaan, C. W. (2019). Early mobilization protocols for critically ill pediatric patients: systematic review. Protocolos de mobilização precoce no paciente crítico pediátrico: revisão sistemática. Revista Brasileira de terapia intensiva, 31(2), 248–257. https://doi.org/10.5935/0103-507X.20190038

Prebio, M., Katz-Papatheophilou, E., Heindl, W., Gelbmann, H., & Burghuber, O. C. (2005). Verminderung von Hautdefekten bei Bauchlagerung bei beatmeten Intensivpatienten durch das Prone-Head-Support-System: eine Pilotstudie [Reduction of pressure sores during prone positioning of ventilated intensive care patients by the prone-head support system: a pilot study]. Wiener klinische Wochenschrift, 117(3), 98–105. https://doi.org/10.1007/s00508-004-0299-2

Puthucheary, Z. A., Rawal, J., McPhail, M., Connolly, B., Ratnayake, G., Chan, P., Hopkinson, N. S., Phadke, R., Dew, T., Sidhu, P. S., Velloso, C., Seymour, J., Agley, C. C., Selby, A., Limb, M., Edwards, L. M., Smith, K., Rowlerson, A., Rennie, M. J., Moxham, J., & Montgomery, H. E. (2013). Acute skeletal muscle wasting in critical illness. JAMA, 310(15), 1591–1600. https://doi.org/10.1001/jama.2013.278481

Simpson, R., & Robinson, L. (2020). Rehabilitation After Critical Illness in People With COVID-19 Infection. American journal of physical medicine & rehabilitation, 99(6), 470–474. https://doi.org/10.1097/PHM.0000000000001443

Sommers, J., Engelbert, R. H., Dettling-Ihnenfeldt, D., Gosselink, R., Spronk, P.E., Nollet, F., et al. Fisioterapia na unidade de terapia intensiva: uma declaração prática baseada em evidências, orientada por especialistas e recomendações de reabilitação. Clin Reabilitação; 29 (11): 1051-1063. https://doi.org/10.1177/0269215514567156

Sousa, B. V. N., França, J. R. G., & Jesus, V. S. de. (2016). CUIDADOS DE ENFERMAGEM NA PREVENÇÃO DE ÚLCERAS POR PRESSÃO EM UNIDADES DE TERAPIA INTENSIVA: UMA REVISÃO SISTEMÁTICA. Revista Brasileira De Saúde Funcional, 1(2), 16. Recuperado de https://seer-adventista.com.br/ojs3/index.php/RBSF/article/view/709

Stiller, K. (2013). Physiotherapy in intensive care: an updated systematic review. Chest; 144(3):825-847. https://doi.org/10.1378/chest.12-2930.

Thomas, P., Baldwin, C., Bissett, B., Boden, I., Gosselink, R., Granger, C. L., Hodgson, C., Jones, A. Y., Kho, M. E., Moses, R., Ntoumenopoulos, G., Parry, S. M., Patman, S., & van der Lee, L. (2020). Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. Journal of physiotherapy, 66(2), 73–82. https://doi.org/10.1016/j.jphys.2020.03.011

Tipping, C. J., Harrold, M., Holland, A., Romero, L., Nisbet, T., & Hodgson, C. L. (2017). The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive care medicine, 43(2), 171–183. https://doi.org/10.1007/s00134-016-4612-0

Vanderwee, K., Grypdonck, M. H., & Defloor, T. (2005). Effectiveness of an alternating pressure air mattress for the prevention of pressure ulcers. Age and ageing, 34(3), 261–267. https://doi.org/10.1093/ageing/afi057

Voggenreiter, G., Aufmkolk, M., Stiletto, R. J., Baacke, M. G., Waydhas, C., Ose, C., Bock, E., Gotzen, L., Obertacke, U., & Nast-Kolb, D. (2005). Prone positioning improves oxygenation in post-traumatic lung injury--a prospective randomized trial. The Journal of trauma, 59(2), 333–343. https://doi.org/10.1097/01.ta.0000179952.95921.49

Young T. (2004). The 30 degree tilt position vs the 90 degree lateral and supine positions in reducing the incidence of non-blanching erythema in a hospital inpatient population: a randomised controlled trial. Journal of tissue viability, 14(3), 88–96. https://doi.org/10.1016/s0965-206x(04)43004-6

Published

18/07/2022

How to Cite

OLIVEIRA , R. C. .; SANTOS , J. E. C. .; SANTOS, A. P. dos .; SOUZA, A. C. de F. .; FERREIRA, M. E. R. .; SILVA, J. P. R. .; SILVA JÚNIOR, W. M. da .; MACIEL, L. Y. dos S. .; FARIAS NETO, J. P. de . Mobilization strategies in minimizing pressure injuries in patients in the hospital setting. Research, Society and Development, [S. l.], v. 11, n. 9, p. e54811932173, 2022. DOI: 10.33448/rsd-v11i9.32173. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32173. Acesso em: 22 dec. 2024.

Issue

Section

Health Sciences