scholarly journals Impact of a Nutritional Formula Enriched in Fish Oil and Micronutrients on Pressure Ulcers in Critical Care Patients

2012 ◽  
Vol 21 (4) ◽  
pp. e102-e109 ◽  
Author(s):  
M. Theilla ◽  
B. Schwartz ◽  
J. Cohen ◽  
H. Shapiro ◽  
R. Anbar ◽  
...  
Keyword(s):  
Critical Care ◽  
Fish Oil ◽  
Pressure Ulcers ◽  
Critical Care Patients

Enteral Nutrition in the Prevention and Treatment of Pressure Ulcers in Adult Critical Care Patients

2014 ◽  
Vol 34 (6) ◽  
pp. 15-27 ◽  
Author(s):  
Jill Cox ◽  
Louisa Rasmussen
Keyword(s):  
Wound Healing ◽  
Critical Care ◽  
Nutritional Status ◽  
Pressure Ulcers ◽  
Burden Of Illness ◽  
Evidence Based ◽  
Adequate Nutrition ◽  
Nutritional Guidelines ◽  
Registered Dietician ◽  
Critical Care Patients

Prevention and healing of pressure ulcers in critically ill patients can be especially challenging because of the patients’ burden of illness and degree of physiological compromise. Providing adequate nutrition may help halt the development or worsening of pressure ulcers. Optimization of nutrition can be considered an essential ingredient in prevention and healing of pressure ulcers. Understanding malnutrition in critical care patients, the effect of nutrition on wound healing, and the application of evidence-based nutritional guidelines are important aspects for patients at high risk for pressure ulcers. Appropriate screenings for nutritional status and risk for pressure ulcers, early collaboration with a registered dietician, and administration of appropriate feeding formulations and micronutrient and macronutrient supplementation to promote wound healing are practical solutions to improve the nutritional status of critical care patients. Use of nutritional management and enteral feeding protocols may provide vital elements to augment nutrition and ultimately result in improved clinical outcomes.

scholarly journals Predicting the Risk for Hospital-Acquired Pressure Ulcers in Critical Care Patients

2017 ◽  
Vol 37 (4) ◽  
pp. e1-e11 ◽  
Author(s):  
Xiaohong Deng ◽  
Ting Yu ◽  
Ailing Hu
Keyword(s):  
Logistic Regression ◽  
Critical Care ◽  
Intensive Care ◽  
Decision Tree ◽  
Pressure Ulcers ◽  
Prediction Models ◽  
Risk Prediction Models ◽  
Braden Scale ◽  
Hospital Acquired ◽  
Critical Care Patients

BACKGROUND Assessments of risk for pressure ulcers in critical care patients may not include important predictors. OBJECTIVE To construct risk-prediction models of hospital-acquired pressure ulcers in intensive care patients and compare the models’ predictive validities with validity of the Braden Scale. METHODS Data were collected retrospectively on patients admitted to intensive care from October 2011 through October 2013. Logistic regression and decision trees were used to construct the risk-prediction models. Predictive validity was measured by using sensitivity, specificity, positive and negative predictive values, and area under the curve. RESULTS With logistic regression analysis, 6 factors were significant independent predictors. With the decision tree, 4 types of high-risk populations were identified. Predictive validity of Braden Scale scores was lower than the validities of the logistic regression and the decision tree models. CONCLUSION Risk for hospital-acquired pressure ulcers is overpredicted with the Braden Scale, with low specificity and low positive predictive value

Evidence-Based Prevention of Pressure Ulcers in the Intensive Care Unit

2013 ◽  
Vol 33 (6) ◽  
pp. 57-66 ◽  
Author(s):  
Karen L. Cooper
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Critical Care Unit ◽  
Pressure Ulcers ◽  
Hemodynamic Instability ◽  
Evidence Based ◽  
Never Event ◽  
Vasoactive Medications ◽  
Critical Care Patients

The development of stage III or IV pressure ulcers is currently considered a never event. Critical care patients are at high risk for development of pressure ulcers because of the increased use of devices, hemodynamic instability, and the use of vasoactive medications. This article addresses risk factors, risk scales such as the Norden, Braden, Waterlow, and Jackson-Cubbin scales used to determine the risk of pressure ulcers in critical care patients, and prevention of device-related pressure ulcers in patients in the critical care unit.

scholarly journals Povezave med razjedo zaradi pritiska in ohranjanjem integritete kože pacienta v intenzivni zdravstveni obravnavi: pregled literature

2015 ◽  
Vol 49 (4) ◽  
Author(s):  
Dragica Emeđi ◽  
Brigita Skela-Savič
Keyword(s):  
Critical Care ◽  
Quality Of Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Pressure Ulcer Prevention ◽  
Skin Integrity ◽  
Prevention And Treatment ◽  
Critical Care Patients ◽  
Ulcer Prevention

Uvod: Namen raziskave je prikazati večdimenzionalne potrebe in možne dejavnike tveganja za razjedo zaradi pritiska pri odraslih pacientih v intenzivni zdravstveni obravnavi. Metode: Uporabili smo analizo in sintezo pregleda dokazov iz zbirke podatkov EMERALD, CINAHL, PubMed in ProQuest. Ključne iskalne besedne zveze so bile: »quality of care«, »pressure ulcer«, »prevention and treatment of pressure ulcers«, »skin integrity critical care patients«. Omejitveni kriteriji iskanja so bili: obdobje 2010 do 2013, celotno besedilo člankov v angleščini. Začetna merila je izpolnjevalo 280 zadetkov in 40 izbranih ustreznih prispevkov. Potek raziskave je prikazan v skladu z načeli Cochranove zbirke, ocena kakovosti dokazov pa v hierarhiji dokazov. Rezultati: Identificiranih je 191 kod, ki so združene v 11 vsebinskih kategorij: okolje intenzivne terapije – značilnosti nekaterih dejavnikov tveganja, čas bivanja v enoti, vazoaktivne učinkovine, spol, starost, administrativno diagnostična kategorija, postelja, ležišče, lestvica Waterlow, razjeda zaradi pritiska in pomen prve stopnje razjede. Diskusija in zaključek: Raziskava pokaže pomen uvedbe proaktivnih ukrepov za ohranjanje integritete kože pacienta. Osredotoča se na vitalnost tkiva in promocijo kakovostne zdravstvene oskrbe z vidika teorije. Potrebne so raziskave, ki bi za boljše razumevanje pojasnjevale številna druga tveganja in učinkovite programe za vitalnost kože.

Predictors of Pressure Ulcers in Adult Critical Care Patients

2011 ◽  
Vol 20 (5) ◽  
pp. 364-375 ◽  
Author(s):  
Jill Cox
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Ulcers ◽  
Critical Care Patients

BackgroundPressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate. Currently, consensus is lacking on the most important risk factors for pressure ulcers in critically ill patients, and no risk assessment scale exclusively for pressure ulcers in these patients is available.ObjectiveTo determine which risk factors are most predictive of pressure ulcers in adult critical care patients. Risk factors investigated included total score on the Braden Scale, mobility, activity, sensory perception, moisture, friction/shear, nutrition, age, blood pressure, length of stay in the intensive care unit, score on the Acute Physiology and Chronic Health Evaluation II, vasopressor administration, and comorbid conditions.MethodsA retrospective, correlational design was used to examine 347 patients admitted to a medical-surgical intensive care unit from October 2008 through May 2009.ResultsAccording to direct logistic regression analyses, age, length of stay, mobility, friction/shear, norepinephrine infusion, and cardiovascular disease explained a major part of the variance in pressure ulcers.ConclusionCurrent risk assessment scales for development of pressure ulcers may not include risk factors common in critically ill adults. Development of a risk assessment model for pressure ulcers in these patients is warranted and could be the foundation for development of a risk assessment tool.

scholarly journals The pathophysiology of “happy” hypoglycemia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Thomas Loeb ◽  
Anna Ozguler ◽  
Geraldine Baer ◽  
Michel Baer
Keyword(s):  
Critical Care ◽  
Hemorrhagic Shock ◽  
Lactate Production ◽  
Severe Hypoglycemia ◽  
Altered Mental Status ◽  
Case Presentation ◽  
Energy Substrate ◽  
Tissue Hypoperfusion ◽  
The Brain ◽  
Critical Care Patients

Abstract Background Hypoglycemia usually includes various neurological symptoms, which are the consequence of neuroglycopenia. When it is severe, it is associated with altered mental status, even coma. Case presentation We report the case of a patient with severe hypoglycemia, completely asymptomatic, due to the increase of lactate production in response to tissue hypoperfusion following a hemorrhagic shock. This illustrates that lactate can substitute glucose as an energy substrate for the brain. It is also a reminder that this metabolite, despite its bad reputation maintained by its role as a marker of severity in critical care patients, has a fundamental role in our metabolism. Conclusions Following the example of the “happy hypoxemia” recently reported in the literature describing asymptomatic hypoxemia in COVID-19 patients, we describe a case of “happy hypoglycemia.”

scholarly journals Frequency of repositioning for preventing pressure ulcers in patients hospitalized in ICU: protocol of a cluster randomized controlled trial

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Olga L. Cortés ◽  
Mauricio Herrera-Galindo ◽  
Juan Carlos Villar ◽  
Yudi A. Rojas ◽  
María del Pilar Paipa ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Critical Care ◽  
Pressure Ulcers ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Link Type ◽  
Cluster Randomized ◽  
The Impact

Abstract Background Despite being considered preventable, ulcers due to pressure affect between 30 and 50% of patients at high and very high risk and susceptibility, especially those hospitalized under critical care. Despite a lack of evidence over the efficacy in prevention against ulcers due to pressure, hourly repositioning in critical care as an intervention is used with more or less frequency to alleviate pressure on patients’ tissues. This brings up the objective of our study, which is to evaluate the efficacy in prevention of ulcers due to pressure acquired during hospitalization, specifically regarding two frequency levels of repositioning or manual posture switching in adults hospitalized in different intensive care units in different Colombian hospitals. Methods A nurse-applied cluster randomized controlled trial of parallel groups (two branches), in which 22 eligible ICUs (each consisting of 150 patients), will be randomized to a high-frequency level repositioning intervention or to a conventional care (control group). Patients will be followed until their exit from each cluster. The primary result of this study is originated by regarding pressure ulcers using clusters (number of first ulcers per patient, at the early stage of progression, first one acquired after admission for 1000 days). The secondary results include evaluating the risk index on the patients’ level (Hazard ratio, 95% IC) and a description of repositioning complications. Two interim analyses will be performed through the course of this study. A statistical difference between the groups < 0.05 in the main outcome, the progression of ulcers due to pressure (best or worst outcome in the experimental group), will determine whether the study should be put to a halt/determine the termination of the study. Conclusion This study is innovative in its use of clusters to advance knowledge of the impact of repositioning as a prevention strategy against the appearance of ulcers caused by pressure in critical care patients. The resulting recommendations of this study can be used for future clinical practice guidelines in prevention and safety for patients at risk. Trial registration PENFUP phase-2 was Registered in Clinicaltrials.gov (NCT04604665) in October 2020.

scholarly journals Improving glycemic control in critical care patients

2008 ◽  
Vol 3 (4) ◽  
pp. 30-35
Author(s):  
Julie L. Stone ◽  
Linda L. Hutchinson
Keyword(s):  
Critical Care ◽  
Glycemic Control ◽  
Critical Care Patients
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