Resumen
Este estudio analizó el impacto de COVID-19 en el control autonómico cardíaco en pacientes de la UCI que recibieron ventilación mecánica.
Los pacientes COVID-19 positivos que recibieron ventilación mecánica mostraron una reducción en los componentes vagales del control autonómico cardíaco en comparación con los pacientes COVID-19 negativos.
Estos hallazgos son relevantes para los fisioterapeutas, ya que las alteraciones en el control autonómico están asociadas con un mayor riesgo de muerte cardíaca.
Por lo tanto, es importante que los fisioterapeutas estén al tanto de los posibles efectos de COVID-19 en el sistema cardiovascular y utilicen medidas preventivas y terapéuticas adecuadas para minimizar el riesgo de complicaciones cardíacas en pacientes con COVID-19.
Impacto de la fisioterapia en el control autonómico de pacientes COVID-19 ventilados mecánicamente
El COVID-19 afecta la función autonómica cardiaca en pacientes sometidos a ventilación mecánica. La fisioterapia emerge como una herramienta valiosa en la recuperación de estos pacientes, al mejorar el control autonómico y contribuir a su bienestar. Es esencial que las clínicas de fisioterapia implementen protocolos adecuados para tratar a estos pacientes de manera efectiva y segura.
Abstract original
Autonomic dysfunction in COVID-19 patients receiving mechanical ventilation: A cross-sectional study
Background: Coronavirus disease 2019 (COVID-19) can damage cardiac tissue by increasing troponin levels and inducing arrhythmias, myocarditis, and acute coronary syndrome.
Objectives: To analyze the impact of COVID-19 on cardiac autonomic control in mechanically ventilated intensive care unit (ICU) patients.
Design and setting: This cross-sectional analytical study of ICU patients of both sexes receiving mechanical ventilation was conducted in a tertiary hospital.
Methods: Patients were divided into COVID-19-positive (COVID(+)) and COVID-19-negative (COVID(-)) groups. Clinical data were collected and heart rate variability (HRV) records obtained using a heart rate monitor.
Results: The study sample comprised 82 subjects: 36 (44%) in the COVID(-) group (58.3% female; median age, 64.5 years) and 46 (56%) in the COVID(+) group (39.1% females; median age, 57.5 years). The HRV indices were lower than the reference values. An intergroup comparison identified no statistically significant differences in the mean normal-to-normal (NN) interval, standard deviation of the NN interval, or root mean square of successive differences in NN intervals. The COVID(+) group had an increased low frequency (P = 0.05), reduced high frequency (P = 0.045), and increased low frequency/high frequency (LF/HF) ratio (P = 0.048). There was a weak positive correlation between LF/HF and length of stay in the COVID(+) group.
Conclusion: Patients who received mechanical ventilation had lower overall HRV indices. COVID(+) patients who received mechanical ventilation had lower vagal HRV components. These findings likely indicate clinical applicability, as autonomic control impairments are associated with a greater risk of cardiac death.
| Autores | Renata Baltar da Silva Victor Ribeiro Neves Mayara Costa Barros Bruno Bavaresco Gambassi Paulo Adriano Schwingel Dário Celestino Sobral Filho |
| revista | Sao Paulo Med J |
| DOI | 10.1590/1516-3180.2022.0513.R1.09022023 |