目的:为了确定身体形态,骶骨皮肤微气候及其对重症监护病房患者压力损伤发展和风险的影响。
方法:一项为期30周的前瞻性观察性探索性研究。每周多次重复研究观察,持续28天或直至出院。参与者纳入标准为≥18岁,预计重症监护住院时间>24小时,骶骨区域皮肤完整。
方法:这项研究是在昆士兰州一家主要大都市公立医院的36张病床的重症监护室进行的,澳大利亚。
方法:压力伤根据国际压力伤分类系统进行分级和独立验证。压力性损伤风险由Braden量表评分和表皮下水肿确定,在骶骨处使用表皮下水分扫描仪.
结果:在招募的93名参与者中,倒三角形体形状(p=.049),BMI>25kg/m2(p=.008),根据表皮下水肿,标准泡沫床垫类型(p=.017)和住院时间延长(p<.001)与压力损伤风险增加相关.骶骨皮肤温度升高的参与者(p<0.001),机械通气(p<.001),服用血管活性药物(p=0.003),序贯器官衰竭评估评分增加(p=.047),根据Braden量表评分,神经血管诊断(p=.031)和住院时间增加(p=.027)与压力性损伤风险增加相关.
结论:身体形态和皮肤微气候与危重病期间的压力损伤风险相关。
结论:表皮下水肿与患者的形状有关,身体质量指数和床垫类型,直接影响压力负荷和皮肤的因素,而Braden量表与骶骨温度和危重病的临床指标相关。在压力损伤风险评估中考虑身体形态和皮肤微气候可能导致针对高危患者的更具体的预防策略。
OBJECTIVE: To determine the association between body morphology, sacral skin
microclimate and their impact on the development and risk of pressure injuries among patients in an intensive care unit.
METHODS: A prospective observational exploratory
study was conducted over 30 weeks. Repeat
study observations occurred multiple times a week for 28 days or until discharge. Participant inclusion criteria were ≥ 18 years of age, expected intensive care length of stay > 24 h and intact skin over the sacrum region.
METHODS: The
study was conducted in a 36-bed intensive care unit of a major metropolitan public hospital in Queensland, Australia.
METHODS: Pressure injuries were staged and independently verified according to the international pressure injury classification system. Pressure injury risk was determined by the Braden scale score and subepidermal oedema, using a subepidermal moisture scanner at the sacrum.
RESULTS: Of the 93 participants recruited, an inverted triangle body shape (p =.049), a BMI > 25 kg/m2 (p =.008), a standard foam mattress type (p =.017) and increased length of stay (p <.001) were associated with an increased pressure injury risk according to subepidermal oedema. Participants with increased sacral skin temperature (p <.001), mechanical ventilation (p <.001), vasoactive drugs administered (p =.003), increased sequential organ failure assessment score (p =.047), neurovascular diagnosis (p =.031) and increased length of stay (p =.027) were associated with increased pressure injury risk according to the Braden scale score.
CONCLUSIONS: Body morphology and skin microclimate are associated with pressure injury risk during critical illness.
CONCLUSIONS: Subepidermal oedema was associated with a patient\'s shape, body mass index and mattress type, factors that directly influence the pressure loading and the skin, whereas the Braden scale was associated with sacral temperature and clinical measures of critical illness. Consideration of body morphology and skin
microclimate in pressure injury risk assessment could lead to more specific prevention strategies targeting high risk patients.