Cuidado multiprofissional na Fraqueza Muscular Adquirida na UTI em adultos: revisão de escopo
DOI:
https://doi.org/10.15343/0104-7809.202650e18952025IPalavras-chave:
Fraqueza Muscular, Deambulação Precoce, Prevenção de Doenças, Cuidados Críticos, Unidades de Terapia IntensivaResumo
Esta revisão de escopo teve como objetivo mapear evidências sobre recomendações e protocolos de cuidado multiprofissional para adultos com FMA-UTI, identificando práticas e lacunas na literatura. Foi conduzida conforme metodologia do Joanna Briggs Institute e reportada segundo o PRISMA-ScR. A busca foi realizada em março de 2025 nas bases MEDLINE/PubMed, BVS, Scopus, Web of Science e Cochrane Library, utilizando descritores DeCS/MeSH combinados a termos livres. Foram incluídos artigos originais, revisões e diretrizes clínicas publicados a partir de 2020, nos idiomas inglês, português ou espanhol. Foram identificados 734 registros, dos quais 373 permaneceram após a remoção de duplicatas. Após triagem e leitura na íntegra, 17 estudos foram incluídos. Os achados indicam a utilização de estratégias como mobilização precoce, estimulação elétrica neuromuscular e organização do cuidado multiprofissional no manejo da FMA-UTI. Observou-se heterogeneidade entre as intervenções e ausência de protocolos amplamente padronizados e integrados no contexto da terapia intensiva. Conclui-se que, embora existam diferentes estratégias descritas na literatura, persistem lacunas relacionadas à padronização e à integração do cuidado multiprofissional, evidenciando a necessidade de estudos que subsidiem a consolidação de recomendações mais consistentes para a prática clínica.
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Este artigo é uma tradução em English do artigo:
Cuidado multiprofissional na Fraqueza Muscular Adquirida na UTI em adultos: revisão de escopo
Referências
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Machado JC, Castro MG, Giacomassi IWS, Giorelli GV, Isola AM, Silva Junior JM, et al. Bundles no combate à fraqueza adquirida na unidade de terapia intensiva. BRASPEN J. 2023;36(2):131-144. doi:10.37111/braspenj.2021.36.2.01.
Zhang Y, Hu Q, Zhou M, Wang Y, Yang J, Jin X, et al. Risk factors for acquired weakness in intensive care unit patients: an umbrella review. Intensive Crit Care Nurs. 2025;88:103940. doi:10.1016/j.iccn.2025.103940.
García-Pérez-de-Sevilla G, Sánchez-Pinto B. Effectiveness of physical exercise and neuromuscular electrical stimulation interventions to prevent and treat ICU-acquired weakness: a systematic review of randomized clinical trials. Intensive Crit Care Nurs. 2023;74:103333. doi:10.1016/j.iccn.2022.103333.
Zhang L, Hu W, Cai Z, Liu J, Wu J, Deng Y, et al. Early mobilization of critically ill patients in the intensive care unit: a systematic review and meta analysis. PLoS One. 2019;14(10):e0223185. doi:10.1371/journal.pone.0223185.
Yang T, Li Z, Jiang L, Xi X. Corticosteroid use and intensive care unit-acquired weakness: a systematic review and meta-analysis. Crit Care. 2018;22(1):187. doi:10.1186/s13054-018-2111-0.
Yang T, Li ZQ, Li HL, Zhou JX, Chen GQ. Aminoglycoside use and intensive care unit-acquired weakness: a systematic review and meta-analysis. PLoS One. 2020;15(3):e0230181. doi:10.1371/journal.pone.0230181.
Sun R, Jiang H, Wang J, Yu J, Zhou Q, Fang K, et al. Summary of the best evidence for early exercise rehabilitation in patients with mechanically ventilated ICU-acquired weakness. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024;36(7):745-752. doi:10.3760/cma.j.cn121430-20240227-00169.
Nakanishi N, Yoshihiro S, Kawamura Y, Aikawa G, Shida H, Shimizu M, et al. Effect of neuromuscular electrical stimulation in patients with critical illness: an updated systematic review and meta-analysis of randomized controlled trials. Crit Care Med. 2023;51(10):1386-1396. doi:10.1097/ CCM.0000000000005941.
Anekwe DE, Biswas S, Bussières A, Spahija J. Early rehabilitation reduces the likelihood of developing intensive care unit-acquired weakness: a systematic review and meta-analysis. Physiotherapy. 2020;107:1-10. doi:10.1016/j.physio.2019.12.004.
Klawitter F, Walter U, Axer H, Ehler J. Intensive care unit-acquired weakness: diagnostic value of neuromuscular ultrasound. Anaesthesiologie. 2023;72(8):543-554. doi:10.1007/s00101-023-01300-5.
Yang T, Wang Y, Xi X, Yu S. Association between vasopressor use and intensive care unit-acquired weakness: a meta-analysis. Brain Behav. 2024;14(9):e70012. doi:10.1002/brb3.70012.
García-Martínez MÁ, Montejo González JC, García-de-Lorenzo y Mateos A, Teijeira S. Muscle weakness: understanding the principles of myopathy and neuropathy in the critically ill and management options. Clin Nutr. 2020;39(5):1331-1344. doi:10.1016/j.clnu.2019.05.027.
Elkalawy H, Sekhar P, Abosena W. Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review. Acute Crit Care. 2023;38(4):409-424. doi:10.4266/acc.2023.00703.
Raurell-Torredà M, Arias-Rivera S, Martí JD, Frade-Mera MJ, Zaragoza-García I, Gallart E, et al. Care and treatments related to intensive care unit acquired weakness: a cohort study. Aust Crit Care. 2021;34(5):435-445. doi:10.1016/j.aucc.2020.12.005.
Xu Q, Tan J, Wang Y, Tang M. Theory- and evidence-based nursing interventions for ICU-acquired weakness prevention in intensive care units: a systematic review. PLoS One. 2024;19(9):e0308291. doi:10.1371/journal.pone.0308291.
Giraldo ND, Carvajal C, Muñoz F, Restrepo MP, García MA, Arias JM, et al. Reducing intensive care unit-acquired weakness with a multicomponent protocol implementation: a quasi-experimental clinical trial. Biomédica. 2023;43(4):438-446. doi:10.7705/biomedica.6947.
Zhou W, Yu L, Fan Y, Shi B, Wang X, Chen T, et al. Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): a dual-center randomized controlled trial. PLoS One. 2022;17(5):e0268599. doi:10.1371/journal.pone.0268599.
Zhou Y, Sun Y, Pan Y, Dai Y, Xiao Y, Yu Y. Risk prediction models for intensive care unit-acquired weakness in critically ill patients: a systematic review. Aust Crit Care. 2025;38(1):101066. doi:10.1016/j.aucc.2024.05.003.
Witteveen E, Wieske L, Sommers J, et al. Early prediction of intensive care unit-acquired weakness: a multicenter external validation study. J Intensive Care Med. 2020;35(6):595-605. doi:10.1177/0885066618771001.
Aquim EE, Bernardo WM, Buzzini RF, Azeredo NS, Cunha LS, Damasceno MC, et al. Brazilian guidelines for early mobilization in intensive care units. Rev Bras Ter Intensiva. 2019;31(4):434-443. doi:10.5935/0103-507X.20190084.
Parra BFCS, Matos LBN, Ferrer R, Toledo DO. SARCPRO: protocolo multiprofissional para o manejo da sarcopenia em pacientes hospitalizados. BRASPEN J. 2023;38(1):27-34.
Toledo DO, Silva DCLE, Santos DMD, Freitas BJ, Dib R, Cordioli RL, et al. Bedside ultrasound is a practical measurement tool for assessing muscle mass. Rev Bras Ter Intensiva. 2017;29(4):476-480. doi:10.5935/0103-507X.20170071.
Yang Z, Wang X, Wang F, Peng Z, Fan Y. A systematic review and meta-analysis of risk factors for intensive care unit-acquired weakness. Medicine (Baltimore). 2022;101(43):e31405. doi:10.1097/MD.0000000000031405.
Machado JC, Castro MG, Giacomassi IWS, Giorelli GV, Isola AM, Silva Junior JM, et al. Bundles no combate à fraqueza adquirida na unidade de terapia intensiva. BRASPEN J. 2023;36(2):131-144. doi:10.37111/braspenj.2021.36.2.01.
Zhang Y, Hu Q, Zhou M, Wang Y, Yang J, Jin X, et al. Risk factors for acquired weakness in intensive care unit patients: an umbrella review. Intensive Crit Care Nurs. 2025;88:103940. doi:10.1016/j.iccn.2025.103940.
García-Pérez-de-Sevilla G, Sánchez-Pinto B. Effectiveness of physical exercise and neuromuscular electrical stimulation interventions to prevent and treat ICU-acquired weakness: a systematic review of randomized clinical trials. Intensive Crit Care Nurs. 2023;74:103333. doi:10.1016/j.iccn.2022.103333.
Zhang L, Hu W, Cai Z, Liu J, Wu J, Deng Y, et al. Early mobilization of critically ill patients in the intensive care unit: a systematic review and meta analysis. PLoS One. 2019;14(10):e0223185. doi:10.1371/journal.pone.0223185.
Yang T, Li Z, Jiang L, Xi X. Corticosteroid use and intensive care unit-acquired weakness: a systematic review and meta-analysis. Crit Care. 2018;22(1):187. doi:10.1186/s13054-018-2111-0.
Yang T, Li ZQ, Li HL, Zhou JX, Chen GQ. Aminoglycoside use and intensive care unit-acquired weakness: a systematic review and meta-analysis. PLoS One. 2020;15(3):e0230181. doi:10.1371/journal.pone.0230181.
Sun R, Jiang H, Wang J, Yu J, Zhou Q, Fang K, et al. Summary of the best evidence for early exercise rehabilitation in patients with mechanically ventilated ICU-acquired weakness. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024;36(7):745-752. doi:10.3760/cma.j.cn121430-20240227-00169.
Nakanishi N, Yoshihiro S, Kawamura Y, Aikawa G, Shida H, Shimizu M, et al. Effect of neuromuscular electrical stimulation in patients with critical illness: an updated systematic review and meta-analysis of randomized controlled trials. Crit Care Med. 2023;51(10):1386-1396. doi:10.1097/ CCM.0000000000005941.
Anekwe DE, Biswas S, Bussières A, Spahija J. Early rehabilitation reduces the likelihood of developing intensive care unit-acquired weakness: a systematic review and meta-analysis. Physiotherapy. 2020;107:1-10. doi:10.1016/j.physio.2019.12.004.
Klawitter F, Walter U, Axer H, Ehler J. Intensive care unit-acquired weakness: diagnostic value of neuromuscular ultrasound. Anaesthesiologie. 2023;72(8):543-554. doi:10.1007/s00101-023-01300-5.
Yang T, Wang Y, Xi X, Yu S. Association between vasopressor use and intensive care unit-acquired weakness: a meta-analysis. Brain Behav. 2024;14(9):e70012. doi:10.1002/brb3.70012.
García-Martínez MÁ, Montejo González JC, García-de-Lorenzo y Mateos A, Teijeira S. Muscle weakness: understanding the principles of myopathy and neuropathy in the critically ill and management options. Clin Nutr. 2020;39(5):1331-1344. doi:10.1016/j.clnu.2019.05.027.
Elkalawy H, Sekhar P, Abosena W. Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review. Acute Crit Care. 2023;38(4):409-424. doi:10.4266/acc.2023.00703.
Raurell-Torredà M, Arias-Rivera S, Martí JD, Frade-Mera MJ, Zaragoza-García I, Gallart E, et al. Care and treatments related to intensive care unit acquired weakness: a cohort study. Aust Crit Care. 2021;34(5):435-445. doi:10.1016/j.aucc.2020.12.005.
Xu Q, Tan J, Wang Y, Tang M. Theory- and evidence-based nursing interventions for ICU-acquired weakness prevention in intensive care units: a systematic review. PLoS One. 2024;19(9):e0308291. doi:10.1371/journal.pone.0308291.
Giraldo ND, Carvajal C, Muñoz F, Restrepo MP, García MA, Arias JM, et al. Reducing intensive care unit-acquired weakness with a multicomponent protocol implementation: a quasi-experimental clinical trial. Biomédica. 2023;43(4):438-446. doi:10.7705/biomedica.6947.
Zhou W, Yu L, Fan Y, Shi B, Wang X, Chen T, et al. Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): a dual-center randomized controlled trial. PLoS One. 2022;17(5):e0268599. doi:10.1371/journal.pone.0268599.
Zhou Y, Sun Y, Pan Y, Dai Y, Xiao Y, Yu Y. Risk prediction models for intensive care unit-acquired weakness in critically ill patients: a systematic review. Aust Crit Care. 2025;38(1):101066. doi:10.1016/j.aucc.2024.05.003.
Witteveen E, Wieske L, Sommers J, et al. Early prediction of intensive care unit-acquired weakness: a multicenter external validation study. J Intensive Care Med. 2020;35(6):595-605. doi:10.1177/0885066618771001.
Aquim EE, Bernardo WM, Buzzini RF, Azeredo NS, Cunha LS, Damasceno MC, et al. Brazilian guidelines for early mobilization in intensive care units. Rev Bras Ter Intensiva. 2019;31(4):434-443. doi:10.5935/0103-507X.20190084.
Parra BFCS, Matos LBN, Ferrer R, Toledo DO. SARCPRO: protocolo multiprofissional para o manejo da sarcopenia em pacientes hospitalizados. BRASPEN J. 2023;38(1):27-34.
Toledo DO, Silva DCLE, Santos DMD, Freitas BJ, Dib R, Cordioli RL, et al. Bedside ultrasound is a practical measurement tool for assessing muscle mass. Rev Bras Ter Intensiva. 2017;29(4):476-480. doi:10.5935/0103-507X.20170071.
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Publicado
2026-05-04
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Aguiar, I. C. V., Souza, F. C. de M., da Silva, F. S., & Barbosa Filho, V. C. (2026). Cuidado multiprofissional na Fraqueza Muscular Adquirida na UTI em adultos: revisão de escopo. O Mundo Da Saúde, 50. https://doi.org/10.15343/0104-7809.202650e18952025I
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