Hiperglicemia e Mobilidade Muscular em Pacientes Críticos com Sepse: Coorte Histórica de Base Hospitalar
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2025.218334Palavras-chave:
Glicemia, Sepse, Polineuropatias, Fraqueza muscularResumo
Objetivo: Avaliar a influência da hiperglicemia sobre a mobilidade em pacientes críticos com sepse. Métodos: Corte histórico de pacientes sépticos internados entre dezembro de 2017 a agosto de 2021 em Unidade de Terapia Intensiva (UTI) de um hospital privado em Joinville, Brasil. Incluiu-se todos os pacientes sobreviventes à sepse maiores de 18 anos, com mais de 48 horas de ventilação mecânica, sem doenças neurológicas ou articulares e com ICU Mobility Scale (IMS) prévio de 10. Pacientes com média das glicemias de controle diário na primeira semana de UTI foram estratificados em dois grupos (grupo 1: ≤180 mg/dl; grupo 2: >180 mg/dl). O desfecho primário foi um IMS<6 na alta da UTI. Um modelo multivariado por regressão logística foi proposto para avaliar as variáveis associadas com o desfecho. Resultados: Dos 307 pacientes, 45% apresentavam idade ≥60 anos, 53% eram do sexo masculino e 76 (24,8%) foram estratificados no grupo 2 de glicemia. Houve uma maior prevalência de IMS <6 no grupo 2 comparado ao grupo 1 (60,5%% vs. 49,3%; p=0,091). Após ajuste do modelo multivariado, o aumento da idade, índice de massa corpórea e tempo de ventilação mecânica, bem como a causa da internação na UTI por COVID-19 foram independentemente associados com IMS<6. Além disso, pacientes no grupo 2 tiveram 85% maior chance de apresentarem IMS<6 (OR=1,85; IC95% 1,01-3,44; p=0,042). Conclusão: Médias glicêmicas superiores a 180 mg/dl durante a primeira semana de UTI estão associadas a um maior comprometimento da mobilidade em pacientes críticos com sepse.
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Direitos autorais (c) 2026 Marina Borges Wageck Horner, Daniela Delwing-de Lima, Glauco Adrieno Westph, Helbert do Nascimento Lima
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
