Intensive Care Unit, ZiekenhuisNetwerk Antwerpen, Campus Stuivenberg, Lange Beeldekensstraat 267, B-2060 Antwerpen 6, Belgium.
J Tissue Viability. 2010 Feb;19(1):7-15. doi: 10.1016/j.jtv.2009.12.001. Epub 2010 Jan 15.
Data on the prevention and treatment of pressure ulcers (PU's) among ICU patients is sparse.
To compare PU outcomes in medial ICU patients nursed on either a reactive mattress overlay (ROHO, ROHO Inc, Belleville, IL, USA) or an active alternating pressure mattress (NIMBUS3, ArjoHuntleigh, Luton Bedfordshire, UK).
Pilot prospective single blind randomised controlled clinical trial.
Two types of pressure redistributing mattress.
Two groups of eight patients.
Patients included in the study were those at high risk (Norton scale <8) or with a PU on admission.
The two groups had similar patient characteristics. However, the NIMBUS 3 group presented with more ulcers per patient on admission (62.5%) and more severe ulcers (20% category 3) while four patients (50%) presented with a single superficial ulcer in the ROHO group. HEALING: The progress of the ulcers showed significant decreases in PU surface area (p=0.05), total PUSH tool score (p=0.01) in the NIMBUS 3 group compared to the ROHO group. In the NIMBUS 3 group 82% of the ulcers improved versus none in the ROHO group (p=0.002) and 18% remained stable versus 33%. None of the ulcers deteriorated in the NIMBUS 3 group versus 67% in the ROHO group (p=0.006). Full thickness wounds (Category 3) were present in 22% of the NIMBUS 3 group versus 0% of the ROHO group on admission and in 0% versus 66.7% (p=0.008) respectively at the end of the pilot study.
Non-blanching erythema occurred equally in both arms at baseline; skin remained intact for the NIMBUS 3 group while 50% in the ROHO group worsened with superficial tissue loss.
This small pilot study suggests that 'active' alternating therapy is a useful adjunct in the care of highly vulnerable patients, while the outcomes may be less favourable when using 'reactive', constant low pressure devices.
关于 ICU 患者压疮（PU）预防和治疗的数据很少。
比较使用反应性床垫覆盖物（ROHO，ROHO Inc，Belleville，IL，美国）或主动交替压力床垫（NIMBUS3，ArjoHuntleigh，Luton Bedfordshire，英国）护理的内科 ICU 患者的 PU 结局。
试点前瞻性单盲随机对照临床试验。
两种类型的压力重新分配床垫。
两组各 8 例患者。
纳入研究的患者为高危（Norton 量表<8）或入院时存在 PU 的患者。
两组患者的一般特征相似。然而，NIMBUS3 组的每位患者入院时溃疡更多（62.5%）且溃疡更严重（20%为 3 类），而 ROHO 组的 4 名患者（50%）入院时只有单个浅表溃疡。愈合：溃疡的进展显示，与 ROHO 组相比，NIMBUS3 组的 PU 表面积（p=0.05）和总 PUSH 工具评分（p=0.01）显著降低。NIMBUS3 组 82%的溃疡有所改善，而 ROHO 组无改善（p=0.002），18%保持稳定，而 33%恶化。NIMBUS3 组无溃疡恶化，而 ROHO 组有 67%恶化（p=0.006）。NIMBUS3 组入院时 22%的溃疡为全层伤口（3 类），而 ROHO 组无全层伤口，而在试验结束时，NIMBUS3 组为 0%，而 ROHO 组为 66.7%（p=0.008）。
基线时，两个组的非苍白性红斑发生率相等；NIMBUS3 组皮肤保持完整，而 ROHO 组的 50%皮肤恶化，出现浅表组织缺失。
这项小型试点研究表明，“主动”交替治疗是护理高度脆弱患者的有用辅助手段，而使用“反应性”、持续低压力装置时，结果可能不太理想。
