Factors Associated with Endotracheal Tube Related Pressure Injury

Objective:report the case of a critical patient with COVID-19 and show the main findings related to the injury considered acute skin failure (ASF), as well as perform his differential diagnosis with preventable pressure injury (PI). Method: observational, longitudinal, case report type study, developed in a hospital in São Paulo, in the intensive care unit (ICU) exclusively for people diagnosed with COVID-19. Data were collected from a single patient between March and September 2020. Results: A patient with complications from COVID-19 developed a skin lesion, initially defined as PI and later reclassified as ASF. The following findings corroborated the diagnosis: prolonged invasive mechanical ventilation, respiratory, renal and cardiac insufficiency and sepsis of respiratory focus. In addition, other aggravating factors, such as the use of vasoactive drugs, hemodynamic instability with intolerance to minimal repositioning, prolonged fasting and disseminated intravascular coagulopathy associated with coronavirus infection. Conclusion: the report shows that there are difficulties for the differential diagnosis between ASF and PI in clinical practice. This is a new concept, and it is essential that health professionals recognize the main factors associated with the appearance of ASF, many of which are also related to the development of PI, highlighting the need for individualized analysis of these injuries, and ensuring the implementation of interventions for prevention and treatment.

Download Full-text

Risk Factors Associated with Prolonged Intubation and Laryngeal Injury

Otolaryngology ◽

10.1177/019459989411100411 ◽

1994 ◽

Vol 111 (4) ◽

pp. 453-459 ◽

Cited By ~ 98

Author(s):

Perry M. Santos ◽

Ali Afrassiabi ◽

Ernest A. Weymuller

Keyword(s):

Risk Factors ◽

Endotracheal Tube ◽

Vocal Cord ◽

Nasogastric Tube ◽

Histamine Receptor ◽

True Vocal Cord ◽

Survival Group ◽

Prolonged Intubation ◽

Factors Associated ◽

Laryngeal Injury

A prospective study evaluated potential risk factors associated with laryngeal Injury after prolonged endotracheal tube intubation for longer than 3 days. Ninety-seven patients were evaluated after oral endotrachael tube intubation (mean, 9 days). This study updates a previously reported evaluation of 44 patients. The additional sample size has provided findings of unreported patient risk factors of laryngeal injury and confirmation of previous associations. The majority of the 97 patients had some type of laryngeal injury, ranging from mild mucosal erythema to ulceration, granuloma formation, or true vocal cord immobility. Patient examinations were continued until the larynx returned to normal or stabilized or the patient was lost to follow-up. Postextubation examinations in the survival group revealed the following. (1) Laryngeal erythema occurred in 94%, and ulceration occurred in 76% of the patients with resolution within 6 weeks. (2) Laryngeal granulomas occurred in 44% of the patients; the majority of the granulomas (57%) developed an average of 4 weeks after extubation. Associated risk factors included duration of endotracheal tube Intubation ( p < 0.05) and presence of nasogastric tube ( p < 0.05). (3) Vocal cord immobility was observed in 16 patients (20%). Eight patients had true vocal cord immobility noted initially after extubation, and the remaining eight had true vocal cord immobility an average of 4 weeks after extubation. Initial and delayed true vocal cord immobility were associated with duration of intubation and size of endotracheal tube ( p < 0.01). Delayed true vocal cord immobility developed only in patients with a size 8 endotracheal tube. Implications generated from this study would suggest the use of antacids and histamine, receptor antagonist medications for patients requiring a nasogastric tube and the use of smaller diameter endotracheal tubes.

Download Full-text

Dysphagia, Immobility, and Diet Acceptance: Main Factors Associated with Increased Risk of Pressure Injury in Patients Hospitalized after Stroke

Advances in Skin & Wound Care ◽

10.1097/01.asw.0000694140.54146.75 ◽

2020 ◽

Vol 33 (10) ◽

pp. 527-532

Author(s):

Mairin Schott ◽

Anieli Golin ◽

Sibila Reck de Jesus ◽

Bruna Pessoa Alves ◽

Leonardo Dachi ◽

...

Keyword(s):

Factors Associated ◽

Increased Risk ◽

Pressure Injury ◽

Main Factors

Download Full-text

Faktor-Faktor yang Berhubungan dengan Pressure Injury pada Anak

Jurnal Penelitian Kesehatan SUARA FORIKES (Journal of Health Research Forikes Voice) ◽

10.33846/sf.v11i1.560 ◽

2019 ◽

Vol 11 (1) ◽

pp. 13

Author(s):

Juairiah Juairiah

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Medical Devices ◽

Medical Condition ◽

Group Development ◽

Multiple Organ ◽

Google Scholar ◽

Related Factors ◽

Factors Associated ◽

Pressure Injury

Children are vulnerable group to pressure injuries and has unique characteristics as associated factor. Factors related to pressure injury must be slightly different from adult. The intervention action considering the injury to the child must be specifically related to the factors associated with pressure in the child. The purpose of this study is to identify factors associated with PI in children. This study was carried out using systematic literature review studies. Articles for this study was obtained from Google scholar, Science-direct, PubMed, and Ebsco. Articles was published in 2009-2019 that discuss factors related to PI in children. The results of the study was factors related to PI in pediatric patients were divided into 3 categories, they were medical conditions, medical devices, and length of stay. Medical devices were direct trigger factors that causing PI in children. The most common medical devices identified in the study that causing PI were respiration aids such as ventilator. The medical condition was unpreventable factors of PI in children especially Multiple Organ Dysfunction (MODS) and comorbidities, as well as cardiovascular and respiratory disease. Long days of stay increase the risk of PI in children, importantly in the 7th day or more of stay. Prevention of PI in children must be done intensively and should be carried out according to the unique factors of the children group. Development of prevention bundles of PI in children must be done according to pediatric’s PI related factors. Keywords: child; medical devices; related factors; pressure injuries; pediatric ABSTRAK Anak merupakan kelompok yang rentan terhadap pressure injury dan memiliki karakteristik unik yang perlu diperhatikan. Tindakan intervensi pencegahan pressure injury pada anak harus spesifik terkait dengan faktor yang berhubungan dengan pressure injury pada anak. Tujuan dari studi ini adalah mengidentifikasi faktor yang berhubungan dengan PI pada anak. Studi ini merupakan studi Systematic Literature Review Artikel diperoleh dari Google scholar, Science-direct, PubMed, dan Ebsco. Artikel merupakan artikel yang terbit pada tahun 2009-2019 yang membahas faktor yang berhubungan dengan PI pada anak. Hasil studi mengidentifikasi faktor yang berhubungan dengan PI pasien anak adalah kondisi medis, alat medis, dan lama masa perawatan. Alat medis merupakan faktor pencetus terjadinya PI pada anak. Alat medis yang paling umum menyebabkan PI adalah alat bantuan respirasi seperti ventilator. Kondisi medis menjadi faktor yang tidak dapat dihindari menyebabkan PI pada anak teruatama kondisi medis multiple organ dysfunctions (MODS), kormobiditas, penyakit kardiovaskuler dan respirasi. Lama hari perawatan lebih dari 7 hari meningkatkan risiko PI pada anak. Pencegahan PI pada anak harus dilakukan secara intensif dan memperhatikan faktor unik dari kelompok anak. Pengembangan bundle pencegahan PI khusus untuk anak harus dilakukan agar intervensi dapat dilakukan sesuai dengan kelompok usia. Kata kunci: anak; alat medis; faktor yang berhubungan; pressure injury; pediatric

Download Full-text