Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Department of Nursing, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Pediatr Crit Care Med. 2020 Sep;21(9):e752-e758. doi: 10.1097/PCC.0000000000002494.
To investigate the efficacy of hydrocolloid dressing in reducing the occurrence rate and severity of nasotracheal tube-related pressure injury.
Randomized controlled trial.
A PICU in a tertiary medical center in southern China.
Pediatric patients received invasive mechanical ventilation via nasotracheal tubes.
The hydrocolloid dressing was cut into an optimal square size, which should cover the area from the nasal columella to the ala.
Eligible participants were randomly allocated to the control group and the experimental group. The participants in the experimental group received hydrocolloid dressing to protect nasal skin from the beginning of nasotracheal intubation, while the participants in the control group received the current care procedure (without hydrocolloid dressing) unless pressure injuries occurred. The hydrocolloid dressing was changed daily to assess the nasal skin. The pressure injury staging system that was redefined and updated by the National Pressure Ulcer Advisory Panel in 2016 was used. The mean duration of nasotracheal intubation was 150.10 ± 117.09 hours in the experimental group and 161.75 ± 120.72 hours in the control group. Forty-five participants had nasotracheal tube-related pressure injuries in control group, whereas 26 patients had in experimental group (72.6% vs 43.3%; absolute difference, 29.3%, 95% CI, 12.5-46%; p = 0.001). The median survival times of the nasal skin integrity were 95.5 hours in the control group and 219.5 hours in the experimental group (p < 0.001).
Hydrocolloid dressing can not only reduce the occurrence rate of nasotracheal tube-related pressure injury in the child with long-term nasotracheal intubation but also improve the endurance of the nasal skin significantly.
探讨水胶体敷料在降低经鼻气管插管相关性压疮发生率和严重程度中的作用。
随机对照试验。
中国南方一家三级医疗中心的 PICU。
接受经鼻气管插管进行有创机械通气的儿科患者。
将水胶体敷料裁剪成最佳正方形大小，大小应覆盖从鼻小柱到鼻翼的区域。
符合条件的参与者被随机分配到对照组和实验组。实验组从经鼻气管插管开始即用水胶体敷料保护鼻皮肤，而对照组在发生压疮之前接受现行护理程序（不使用水胶体敷料）。每天更换水胶体敷料以评估鼻皮肤。使用 2016 年国家压疮咨询小组重新定义和更新的压疮分期系统。实验组的经鼻气管插管平均持续时间为 150.10±117.09 小时，对照组为 161.75±120.72 小时。对照组有 45 名患者发生经鼻气管插管相关性压疮，而实验组有 26 名患者发生（72.6%比 43.3%；绝对差值，29.3%，95%CI，12.5-46%；p=0.001）。对照组鼻皮肤完整性的中位生存时间为 95.5 小时，实验组为 219.5 小时（p<0.001）。
水胶体敷料不仅可以降低长期经鼻气管插管患儿经鼻气管插管相关性压疮的发生率，还可以显著提高鼻皮肤的耐受力。
