The risk of developing Pressure Ulcer and its relation to the patient`s Status and treatment received in na intensive care Unit in Angola.

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Susana Isabel Mendes Pinto ◽  
Marta Regina Soares de Assunção ◽  
Paulo Alves ◽  
Helena Maria Guerreiro José
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Scale Score ◽  
Pressure Ulcers ◽  
Critical Care Patient ◽  
Care Patient ◽  
Average Score ◽  
Braden Scale ◽  
Significant Difference

Background: Pressure ulcers (PU) are common in patients in intensive care unit (ICU). Many factors contribute to this which include the patient´s status and the characteristics and type of the treatment applied in this level of care1-3. In Angola, a low-middle-income country, the study of this topic is still incipient, which makes it relevant to know whether the Braden scale score differs significantly in different groups of critical care patient. De Alirio Martinho Belchior para Todos: 10:40 AM Aims: To determine if there is a statistically significant difference between the risk of developing pressure ulcers, and the groups of patients sorted by the severity of their disease, organ function/ rate of failure and type of the treatment applied in the ICU. On this behalf the following variables were established: patients treated with sedatives, vasoactive drugs, mechanical ventilation, haemodialysis; Braden Scale average score, the APACHE II (Acute Physiology and Chronic Health Evaluation) score, the SOFA (Sequential Organ Failure Assessment) score and the duration of hospitalization (days) in ICU. Methods: An observational, descriptive, prospective and longitudinal study with a quantitative nature was developed in an ICU ward in a hospital in Angola. Results: The sample was composed of 123 patients; the average value of the Braden scale was 14.15 points. Patients being treated with sedatives showed statistically significant difference in the average Braden scale score compared to those who did not. This difference was also verified in relation to the patients who were treated with vasopressors and mechanical ventilation. Negative, moderate to weak, but statistically significant correlations were found between the Braden scale score and the APACHE score, SOFA score and duration of ICU stay. De Alirio Martinho Belchior para Todos: 10:40 AM Conclusion: The patients have a higher risk of developing pressure ulcers when exposed to risk factors that are already known and specifically associated with some treatments implemented in the ICU. Higher rates of disease severity, mortality risk and longer duration of stay in ICU are associated with a higher risk of PU.

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit

2018 ◽  
Vol 42 (2) ◽  
pp. 82-91 ◽  
Author(s):  
M. Lima-Serrano ◽  
M.I. González-Méndez ◽  
C. Martín-Castaño ◽  
I. Alonso-Araujo ◽  
J.S. Lima-Rodríguez
Keyword(s):  
Risk Assessment ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Predictive Validity ◽  
Pressure Ulcers ◽  
Validity And Reliability ◽  
Braden Scale

Pressure ulcer risk factors in an ICU population

1995 ◽  
Vol 4 (5) ◽  
pp. 361-367 ◽  
Author(s):  
MK Jiricka ◽  
P Ryan ◽  
MA Carvalho ◽  
J Bukvich
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Motor Vehicle ◽  
Convenience Sample ◽  
Medical Diagnoses ◽  
Trauma Population ◽  
Braden Scale

BACKGROUND: Although it is well known that pressure ulcers are associated with negative patient outcomes and increased hospital cost, there is little research related to pressure ulcers in an intensive care unit population. OBJECTIVE: To determine the relative contribution of risk factors in the development of pressure ulcers in intensive care unit patients. METHOD: In an exploratory descriptive design, a convenience sample of 85 adults was used. Patients were enrolled in the study within 24 hours of admission to the intensive care unit; data were collected every other day until discharge from the intensive care unit. Instruments included a demographic data form, Braden Scale for Predicting Pressure Sore Risk, Skin Assessment Tool, and Decubitus Ulcer Potential Analyzer. RESULTS: The most common reasons for admission to the intensive care unit included multiple trauma from motor vehicle accidents, gunshot and stab wounds, and gastrointestinal bleeding. A pressure ulcer developed in 48 subjects. There were no significant differences in age, gender, history of diabetes or smoking, or medical diagnoses between patients in whom a pressure ulcer developed and those in whom it did not. Data analysis indicated that a Braden Scale score of 11, rather than the recommended score of 16, was statistically significant for predicting pressure ulcer risk. CONCLUSIONS: The results suggest that a cut-off score on the Braden Scale could be specific to an intensive care unit trauma population.

scholarly journals Escala de Braden: a importância da avaliação do risco de úlcera de pressão em pacientes em uma unidade de terapia intensiva

2016 ◽  
pp. 36
Author(s):  
Cristiane Ribeiro da Costa ◽  
Laís Moreira da Costa ◽  
Daniela Maria Nantes Boução
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Calidad De Vida ◽  
Braden Scale ◽  
Factores De Riesgo ◽  
Terapia Intensiva ◽  
Developed Pressure ◽  
The Impact

As úlceras por pressão (UP) são definidas como lesões cutâneas ou de partes moles, superficiais ou profundas, que ocorrem devido à falta de oxigênio e/ou nutrientes em uma área para preencher as necessidades dos tecidos. A partir da prática na Fundação de Clinicas Gaspar Viana (FHCGV), foi possível observar o impacto na qualidade de vida dos pacientes que foram acometidos no decorrer da internação por úlcera de pressão. É de extrema relevância qualificar a equipe de enfermagem quanto à utilização dos instrumentos e dos recursos. A partir disto compreende-se a utilização de uma escala preditiva (Braden). Através da aplicação desta é possível avaliar o grau de risco de cada paciente, bem como a aplicação da mesma na prevenção de úlcera de pressão em pacientes em uma unidade de terapia intensiva. O objetivo deste trabalho foi identificar o perfil dos pacientes na unidade de terapia intensiva que evoluíram com úlcera de pressão segundo o risco preditivo.Descritores: Enfermagem, Úlcera por Pressão, Fatores de Risco. Braden scale: the importance of evaluation of pressure ulcer risk in patients in an intensive care unitAbstract: Pressure ulcers (PU) are defined as skin injuries or soft tissue, superficial or underlying injuries, that occur due to lack of oxygen and/or nutrients in an area to meet the needs of the tissues. From the practice In the Clinicas Gaspar Viana Foundation (FHCGV), it was possible to observe the impact on the quality of life of the patients that were affected in the course of hopitalization by pressure ulcer.  It is extremely relevant to qualify the nursing staff on the use of instruments and resources. From this comprises the use of a predictive scale (Braden). By applying that, it is possible to assess the degree of risk of each patient, as well as evaluate the application of the later in pressure ulcer prevention in patients at an intensive care unit. The goal of this work is to identify the profile of patients in the intensive care unit that developed pressure ulcers according to the predictive risk.Descriptors: Nursing, Pressure Ulcer, Risk Factors. Escala de Braden: la importancia de la evaluación de riesgo de úlcera de presión en pacientes en una unidad de cuidados intensivosResumen: Las úlceras por presión (UP) se definen como lesiones en la piel o en el tejido blando, superficial o profundo, que ocurren debido a la falta de oxígeno y/o nutriente en un area para satisfacer las necesidades de los tejidos. Partiendo de la práctica en la Fundación de Clínicas Gaspar Viana (FHCGV), fue posible observar el impacto en la calidad de vida de los pacientes que fueron afectados a lo largo de la hospitalización por la úlcera por presión. Es de gran importancia calificar el equipo de enfermería cuanto a la utilización de las herramientas y de los recursos. Partiendo de ahí se puede comprender la utilización de una escala predictiva (Braden). A través de la aplicación de la misma es posible evaluar el grado de riesgo de cada paciente, así como la aplicabilidad de la misma en la prevención de úlceras de presión en pacientes en unidad de cuidados intensivos (UCI). El objetivo de este trabajo fue identificar el perfil de los pacientes en la UCI que evolucionaron con úlceras de presión según el riesgo predictivo.Descriptores: Enfermería, Úlceras por Presión, Factores de Riesgo.

scholarly journals Escala de Braden: a importância da avaliação do risco de úlcera de pressão em pacientes em uma unidade de terapia intensiva

2016 ◽  
Vol 6 (17) ◽  
pp. 36
Author(s):  
Cristiane Ribeiro da Costa ◽  
Laís Moreira da Costa ◽  
Daniela Maria Nantes Boução
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Calidad De Vida ◽  
Braden Scale ◽  
Factores De Riesgo ◽  
Terapia Intensiva ◽  
Developed Pressure ◽  
The Impact

As úlceras por pressão (UP) são definidas como lesões cutâneas ou de partes moles, superficiais ou profundas, que ocorrem devido à falta de oxigênio e/ou nutrientes em uma área para preencher as necessidades dos tecidos. A partir da prática na Fundação de Clinicas Gaspar Viana (FHCGV), foi possível observar o impacto na qualidade de vida dos pacientes que foram acometidos no decorrer da internação por úlcera de pressão. É de extrema relevância qualificar a equipe de enfermagem quanto à utilização dos instrumentos e dos recursos. A partir disto compreende-se a utilização de uma escala preditiva (Braden). Através da aplicação desta é possível avaliar o grau de risco de cada paciente, bem como a aplicação da mesma na prevenção de úlcera de pressão em pacientes em uma unidade de terapia intensiva. O objetivo deste trabalho foi identificar o perfil dos pacientes na unidade de terapia intensiva que evoluíram com úlcera de pressão segundo o risco preditivo.Descritores: Enfermagem, Úlcera por Pressão, Fatores de Risco. Braden scale: the importance of evaluation of pressure ulcer risk in patients in an intensive care unitAbstract: Pressure ulcers (PU) are defined as skin injuries or soft tissue, superficial or underlying injuries, that occur due to lack of oxygen and/or nutrients in an area to meet the needs of the tissues. From the practice In the Clinicas Gaspar Viana Foundation (FHCGV), it was possible to observe the impact on the quality of life of the patients that were affected in the course of hopitalization by pressure ulcer.  It is extremely relevant to qualify the nursing staff on the use of instruments and resources. From this comprises the use of a predictive scale (Braden). By applying that, it is possible to assess the degree of risk of each patient, as well as evaluate the application of the later in pressure ulcer prevention in patients at an intensive care unit. The goal of this work is to identify the profile of patients in the intensive care unit that developed pressure ulcers according to the predictive risk.Descriptors: Nursing, Pressure Ulcer, Risk Factors. Escala de Braden: la importancia de la evaluación de riesgo de úlcera de presión en pacientes en una unidad de cuidados intensivosResumen: Las úlceras por presión (UP) se definen como lesiones en la piel o en el tejido blando, superficial o profundo, que ocurren debido a la falta de oxígeno y/o nutriente en un area para satisfacer las necesidades de los tejidos. Partiendo de la práctica en la Fundación de Clínicas Gaspar Viana (FHCGV), fue posible observar el impacto en la calidad de vida de los pacientes que fueron afectados a lo largo de la hospitalización por la úlcera por presión. Es de gran importancia calificar el equipo de enfermería cuanto a la utilización de las herramientas y de los recursos. Partiendo de ahí se puede comprender la utilización de una escala predictiva (Braden). A través de la aplicación de la misma es posible evaluar el grado de riesgo de cada paciente, así como la aplicabilidad de la misma en la prevención de úlceras de presión en pacientes en unidad de cuidados intensivos (UCI). El objetivo de este trabajo fue identificar el perfil de los pacientes en la UCI que evolucionaron con úlceras de presión según el riesgo predictivo.Descriptores: Enfermería, Úlceras por Presión, Factores de Riesgo.

scholarly journals Obesity May Not Be Associated with 28-Day Mortality, Duration of Invasive Mechanical Ventilation and Length of Intensive Care Unit and Hospital Stay in Critically Ill Patients with Severe Acute Respiratory Syndrome Coronavirus-2: A Retrospective Cohort Study

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 674
Author(s):  
Sjaak Pouwels ◽  
Dharmanand Ramnarain ◽  
Emily Aupers ◽  
Laura Rutjes-Weurding ◽  
Jos van Oers
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Significant Difference

Background and Objectives: The aim of this study was to investigate the association between obesity and 28-day mortality, duration of invasive mechanical ventilation and length of stay at the Intensive Care Unit (ICU) and hospital in patients admitted to the ICU for SARS-CoV-2 pneumonia. Materials and Methods: This was a retrospective observational cohort study in patients admitted to the ICU for SARS-CoV-2 pneumonia, in a single Dutch center. The association between obesity (body mass index > 30 kg/m2) and 28-day mortality, duration of invasive mechanical ventilation and length of ICU and hospital stay was investigated. Results: In 121 critically ill patients, pneumonia due to SARS-CoV-2 was confirmed by RT-PCR. Forty-eight patients had obesity (33.5%). The 28-day all-cause mortality was 28.1%. Patients with obesity had no significant difference in 28-day survival in Kaplan–Meier curves (log rank p 0.545) compared with patients without obesity. Obesity made no significant contribution in a multivariate Cox regression model for prediction of 28-day mortality (p = 0.124), but age and the Sequential Organ Failure Assessment (SOFA) score were significant independent factors (p < 0.001 and 0.002, respectively). No statistically significant correlation was observed between obesity and duration of invasive mechanical ventilation and length of ICU and hospital stay. Conclusion: One-third of the patients admitted to the ICU for SARS-CoV-2 pneumonia had obesity. The present study showed no relationship between obesity and 28-day mortality, duration of invasive mechanical ventilation, ICU and hospital length of stay. Further studies are needed to substantiate these findings.

scholarly journals Sedative use of Dexmedetomidine vs. Propofol after Cardiac Surgery: A critical review and meta-analysis.

2019 ◽  
Author(s):  
Hesham Abowali ◽  
Matteo Paganini ◽  
Ayman Elbadawi ◽  
Enrico Camporesi
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Time Dependent ◽  
Confounding Factors ◽  
Ventilation Time ◽  
Significant Difference ◽  
Mechanical Ventilation Time

Abstract BACKGROUND: The efficacy and safety of dexmedetomidine in sedation for postoperative cardiac surgeries is controversial when compared to propofol. METHODS: A computerized search of Medline, Cochrane and Google Scholar databases was performed through August 2018. Studies evaluating the efficacy of dexmedetomidine versus propofol in the sedation of postoperative cardiac surgery patients were searched. The main study outcomes were divided into time dependent (mechanical ventilation time; time to extubation; length of stay in the intensive care unit and in the hospital) and non-time dependent (delirium, bradycardia, and hypotension). RESULTS: The final analysis included 15 trials with a total of 2488 patients. Time to extubation was significantly reduced in the dexmedetomidine group (Standardized Mean Difference (SMD) = -0.54, 95% Confidence Interval (CI): -0.89 to -0.18, p=0.003), as well as mechanical ventilation time (SMD= -0.71, 95% CI: -1.19 to -0.23, p=0.004). Moreover, the dexmedetomidine group showed a significant reduction in Intensive Care Unit length of stay (SMD= -0.38, 95% CI: -0.60 to -0.16, p=0.001) and hospital length of stay (SMD= -0.39, 95% CI: -0.60 to -0.19, p<0.001). However, these time dependent outcomes could have been affected by several confounding factors, thus limiting the value of these results. Incidence of delirium was reduced in the dexmedetomidine group (OR: 0.47, 95% CI: 0.29 to 0.76, p=0.002), while this group of patients had higher rates of bradycardia (OR: 2.52, 95% CI: 1.15 to 5.55, p=0.021). There was no significant difference in rates of hypotension between the two groups. CONCLUSION: Despite the apparent time advantages afforded by dexmedetomidine over propofol, the former does not show particular overall improvements in postoperative care of cardiac surgery patients. Since time dependent outcomes seems to be affected by several confounding factors, more efforts are needed to analyze factors that could affect sedation in post-cardiac surgery patients and choose unbiased outcomes. KEYWORDS: Dexmedetomidine; propofol; cardiac surgery; postoperative sedation.

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