Azfar Mohammad Feroz, Khan Muhammad Faisal, Alzeer Abdulaziz H
Department of Critical Care, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Saudi J Anaesth. 2013 Jan;7(1):33-6. doi: 10.4103/1658-354X.109805.
Eye care is an essential component in the management of critically ill patients. Standardized eye care can prevent corneal complications in ventilated patients.
This study was designed to compare old and new practices of corneal care for reduction in corneal complications in ventilated patients.
This study was done in three phases each of six month duration. Phase 1 was the ongoing practice of eye care in the unit. Before the start of phase 2, a new protocol was made for eye care. Corneal complications were observed in terms of haziness, dryness, and ulceration. All nursing staffs were educated and made compliant with the new protocol. In phase 2, a follow-up audit was done to check the effectiveness and compliance to protocol. In phase 3, a follow-up audit was started 3 months after phase 2.
In phase 1, total ventilated patients were 40 with 240 ventilator days. The corneal dryness rate was 40 per 1000 ventilator days while the haziness and ulceration rate was 16 per 1000 ventilator days each. In the second phase 2, total ventilated patients were 53 making 561 ventilator days. The rate of corneal haziness and dryness was 3.52 and 1.78 per 1000 ventilator days, respectively, with no case of corneal ulceration. In phase 3, the number of ventilated patients was 91 with 1114 ventilator days. The corneal dryness rate was 2.69 while the haziness and ulceration rate was 1.79 each.
Protocolized eye care can reduce the risk of corneal complications in ventilated patients.
眼部护理是重症患者管理的重要组成部分。标准化的眼部护理可预防机械通气患者发生角膜并发症。
本研究旨在比较角膜护理的新旧方法,以减少机械通气患者的角膜并发症。
本研究分三个阶段进行,每个阶段为期6个月。第1阶段为该科室眼部护理的现行做法。在第2阶段开始前,制定了新的眼部护理方案。从角膜浑浊、干燥和溃疡方面观察角膜并发症。对所有护理人员进行培训,使其遵守新方案。在第2阶段,进行随访审核以检查方案的有效性和依从性。在第3阶段,在第2阶段结束3个月后开始随访审核。
在第1阶段,共有40例机械通气患者,机械通气天数为240天。角膜干燥率为每1000机械通气日40例,而角膜浑浊和溃疡率均为每1000机械通气日16例。在第2阶段,共有53例机械通气患者,机械通气天数为561天。角膜浑浊率和干燥率分别为每1000机械通气日3.52例和1.78例,无角膜溃疡病例。在第3阶段,机械通气患者有91例,机械通气天数为1114天。角膜干燥率为2.69,角膜浑浊和溃疡率均为1.79。
规范化的眼部护理可降低机械通气患者发生角膜并发症的风险。