Reabilitação fisioterapêutica do paciente crítico após ventilação mecânica prolongada: do desmame à recuperação funcional

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Prolonged mechanical ventilation is associated with diaphragmatic dysfunction, intensive care unit-acquired weakness and functional impairments that persist after discharge. This narrative review discusses the role of physiotherapy throughout the trajectory of the critically ill ventilated patient — from weaning to functional recovery — based on real, verifiable scientific literature, summarized in tables and descriptive charts. Inspiratory muscle training has shown benefits for weaning success in patients with difficult or failed weaning; early mobilization showed positive results in smaller trials but neutral results in large multicenter studies, suggesting that dose should be titrated rather than maximized; neuromuscular electrical stimulation stood out in preventing acquired weakness; and structured post-ICU rehabilitation programs were associated with higher weaning, decannulation and survival rates. Physiotherapy structures a continuum of care that goes beyond ventilator liberation and is essential for functional recovery and quality of life of critical illness survivors.