Abstract：
OBJECTIVE: There is scarcity of data on the incidence and factors associated with the occurrence of ocular lesions in critically ill children. The objective was to test the applicability and utility of an ocular assessment scale and to identify risk factors of ocular lesions.
METHODS: Prospective observational study.
METHODS: A tertiary care medical-surgical Paediatric Intensive Care Unit.
METHODS: 194 children without previous ocular disease who stayed in the Paediatric Intensive Care Unit for more than 48 h.
METHODS: An ocular lesions risk scale was designed including risk factors lagophthalmos, eye dryness, conjunctival hyperemia, slow blinking, intubation, sedation, relaxation, face mask and hemodynamic instability. Patients were classified as high-, medium-, and low-risk patients. Corneal lesions were examined by fluorescein staining according to their risk and were confirmed by an ophthalmologist.
RESULTS: 76 patients were examined with fluorescein staining. Thirty-two ocular lesions were detected by nursing staff, 26 confirmed by the ophthalmologist. 53.6% of the high-risk patients developed a corneal lesion. Univariate analysis revealed an association between ocular damage and all factors included in the scale, except for face mask. In the multivariate analysis, ocular lesions were associated with lagophthalmos, hyperemia, invasive mechanical ventilation and inotropic support.
CONCLUSIONS: The scale was useful to detect corneal lesions in critically ill children. The identification of risk factors will enable the development of measures to reduce the incidence of ocular lesions.
CONCLUSIONS: A new, non-validated scale allowed staff to detect eye injuries, study this problem and improve future prevention.
METHODS: Prospective observational study.
METHODS: A tertiary care medical-surgical Paediatric Intensive Care Unit.
METHODS: 194 children without previous ocular disease who stayed in the Paediatric Intensive Care Unit for more than 48 h.
METHODS: An ocular lesions risk scale was designed including risk factors lagophthalmos, eye dryness, conjunctival hyperemia, slow blinking, intubation, sedation, relaxation, face mask and hemodynamic instability. Patients were classified as high-, medium-, and low-risk patients. Corneal lesions were examined by fluorescein staining according to their risk and were confirmed by an ophthalmologist.
RESULTS: 76 patients were examined with fluorescein staining. Thirty-two ocular lesions were detected by nursing staff, 26 confirmed by the ophthalmologist. 53.6% of the high-risk patients developed a corneal lesion. Univariate analysis revealed an association between ocular damage and all factors included in the scale, except for face mask. In the multivariate analysis, ocular lesions were associated with lagophthalmos, hyperemia, invasive mechanical ventilation and inotropic support.
CONCLUSIONS: The scale was useful to detect corneal lesions in critically ill children. The identification of risk factors will enable the development of measures to reduce the incidence of ocular lesions.
CONCLUSIONS: A new, non-validated scale allowed staff to detect eye injuries, study this problem and improve future prevention.
摘要：
目的：关于危重患儿眼部病变的发生率和相关因素的数据很少。目的是测试眼部评估量表的适用性和实用性，并确定眼部病变的危险因素。
方法：前瞻性观察性研究。
方法：三级医疗内科外科儿科重症监护病房。
方法：194名以前没有眼部疾病的儿童，在儿科重症监护病房住院超过48小时。
方法：设计了眼部病变风险量表，其中包括危险因素，眼睛干燥，结膜充血，缓慢闪烁,插管,镇静,放松,面罩和血流动力学不稳定。患者被归类为高，medium-,和低风险患者。根据风险通过荧光素染色检查角膜病变，并由眼科医生确认。
结果：76例患者接受了荧光素染色检查。护理人员发现32个眼部病变，26由眼科医生确认。53.6%的高危患者出现角膜病变。单变量分析显示眼部损伤与量表中包含的所有因素之间存在关联，除了面具。在多变量分析中，眼部病变与眩光相关，充血,有创机械通气和正性肌力支持。
结论：该量表可用于检测危重患儿的角膜病变。危险因素的识别将使减少眼部病变发生率的措施得以发展。
结论：一个新的，未经验证的量表允许员工检测眼睛受伤，研究这个问题并改进未来的预防。
方法：前瞻性观察性研究。
方法：三级医疗内科外科儿科重症监护病房。
方法：194名以前没有眼部疾病的儿童，在儿科重症监护病房住院超过48小时。
方法：设计了眼部病变风险量表，其中包括危险因素，眼睛干燥，结膜充血，缓慢闪烁,插管,镇静,放松,面罩和血流动力学不稳定。患者被归类为高，medium-,和低风险患者。根据风险通过荧光素染色检查角膜病变，并由眼科医生确认。
结果：76例患者接受了荧光素染色检查。护理人员发现32个眼部病变，26由眼科医生确认。53.6%的高危患者出现角膜病变。单变量分析显示眼部损伤与量表中包含的所有因素之间存在关联，除了面具。在多变量分析中，眼部病变与眩光相关，充血,有创机械通气和正性肌力支持。
结论：该量表可用于检测危重患儿的角膜病变。危险因素的识别将使减少眼部病变发生率的措施得以发展。
结论：一个新的，未经验证的量表允许员工检测眼睛受伤，研究这个问题并改进未来的预防。
