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高危心血管术后患者的压疮预防

Pressure ulcer prevention in high-risk postoperative cardiovascular patients.

作者信息

Jackson Melissa, McKenney Teresa, Drumm Jennifer, Merrick Brian, LeMaster Tamara, VanGilder Catherine

机构信息

Saint Joseph Health System, Lexington, Kentucky, KY, USA.

出版信息

Crit Care Nurse. 2011 Aug;31(4):44-53. doi: 10.4037/ccn2011830.

Abstract

BACKGROUND

Little has been published about how to prevent pressure ulcers in severely debilitated, immobile patients in intensive care units.

OBJECTIVE

To present a possible prevention strategy for postoperative cardiovascular surgery patients at high risk for development of pressure ulcers.

METHODS

Staff chose to implement air fluidized therapy beds, which provide maximal immersion and envelopment as a measure for preventing pressure ulcers in patients who (1) required vasopressors for at least 24 hours and (2) required mechanical ventilation for at least 24 hours postoperatively.

RESULTS

Only 1 of 27 patients had a pressure ulcer develop while on the air fluidized therapy bed (February 2008 through August 2008), and that ulcer was only a stage I ulcer, compared with 40 ulcers in 25 patients before the intervention.

CONCLUSIONS

Patients spent a mean of 7.9 days on the mattress, and the cost of bed rental was approximately $18000, which was similar to the cost of treatment of 1 pressure ulcer in stage III or IV (about $40000) and was considered cost-effective.

摘要

背景

关于如何预防重症监护病房中极度虚弱、行动不便患者发生压疮的相关报道很少。

目的

为术后有发生压疮高风险的心血管手术患者提出一种可能的预防策略。

方法

工作人员选择使用气悬浮治疗床,该床能提供最大程度的沉浸和包裹,作为预防以下患者发生压疮的一种措施:(1)术后至少24小时需要血管活性药物支持的患者;(2)术后至少24小时需要机械通气的患者。

结果

在使用气悬浮治疗床期间(2008年2月至2008年8月),27例患者中仅1例发生了压疮,且该压疮仅为I期,而干预前25例患者中有40处压疮。

结论

患者在该床垫上平均使用7.9天,床的租赁费用约为18000美元,这与治疗一处III期或IV期压疮的费用(约40000美元)相近,被认为具有成本效益。

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