目的:探讨无创正压通气患者面部压力性损伤的特点及危险因素。
方法:选择2016年1月至2021年12月在台湾某教学医院接受无创正压通气导致面部压力损伤的患者,导致我们病例组共有108名患者。对照组按年龄和性别与三名使用无创通气但未发生面部压力损伤的急性住院患者相匹配,导致对照组324例患者。
方法:本研究为回顾性病例对照研究。比较病例组不同阶段发生压力性损伤患者的特点,然后确定无创通气相关面部压力性损伤的危险因素。
结果:无创通气使用时间延长,住院时间较长,较低的布雷登量表得分,前一组白蛋白水平较低。涉及无创通气使用持续时间的二元逻辑回归的多变量分析结果表明,使用该设备4-9天和16天的患者比使用该设备3天的患者发生面部压力损伤的风险更大;就Braden量表评分而言,较高的Braden量表评分与较高的面部压力损伤风险相关.此外,白蛋白水平低于正常范围与较高的面部压力损伤风险相关.
结论:压力性损伤在较高阶段的患者使用无创通气的持续时间较长,住院时间较长,较低的布雷登量表分数,和较低的白蛋白水平。因此,使用非侵入性通气的持续时间较长,较低的布雷登量表分数,低白蛋白水平也是无创通气相关面部压力损伤的危险因素.
结论:我们的结果为医院提供了有用的参考,为他们的医疗团队制定预防和治疗面部压力损伤的培训计划,以及起草评估风险的指南,以防止由无创通气引起的面部压力损伤。设备使用的持续时间,布雷登量表得分,尤其是白蛋白水平应认真监测,以减少无创通气治疗的急性住院患者面部压力损伤的发生。
OBJECTIVE: To explore the characteristics and risk factors of facial pressure injuries in patients using noninvasive positive pressure ventilation.
METHODS: Patients who developed facial pressure injuries due to non-invasive positive pressure ventilation at a teaching hospital in Taiwan from January 2016 to December 2021 were selected, resulting in a total of 108 patients in our
case group. A control group was formed by matching each
case by age and gender to three acute inpatients who had used non-invasive ventilation but had not developed facial pressure injuries, resulting in 324 patients in the control group.
METHODS: This study was a retrospective
case-control study. The characteristics of the patients who developed pressure injuries at different stages in the
case group were compared, and the risk factors of non-invasive ventilation-related facial pressure injuries were then determined.
RESULTS: Higher duration of non-invasive ventilation usage, higher length of hospital stay, lower Braden scale score, and lower albumin levels in the former group. The results of multivariate analysis from binary logistic regression involving the duration of non-invasive ventilation usage demonstrated that the patients who used this device for 4-9 days and 16 days were at greater risk of facial pressure injuries than those who used it for 3 days; in terms of the Braden scale score, higher Braden scale scores were correlated with a higher risk of facial pressure injuries. In addition, albumin levels lower than the normal range were correlated with a higher risk of facial pressure injuries.
CONCLUSIONS: Patients with pressure injuries at higher stages had a higher duration of non-invasive ventilation usage, higher length of hospital stay, lower Braden scale scores, and lower albumin levels. Thus, a longer duration of non-invasive ventilation use, lower Braden scale scores, and lower albumin levels were also risk factors for non-invasive ventilation-related facial pressure injuries.
CONCLUSIONS: Our results serve as a useful reference for hospitals, both in creating training programs for their medical teams to prevent and treat facial pressure injuries and in drafting guidelines for assessing risk in order to prevent facial pressure injuries caused by non-invasive ventilation. The duration of device usage, Braden scale scores, and albumin levels in particular should be seriously monitored to reduce the occurrence of facial pressure injuries in acute inpatients treated with non-invasive ventilation.