入住 ICU 患者经气管插管相关压力性损伤的危险因素。

Risk Factors of Endotracheal Intubation-Related Pressure Injury among Patients Admitted to the ICU.

机构信息

At the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China, Lili Qin, MD, is Head Nurse, Department of Nursing; Wenjuan Yun, MD, is Head Nurse, Intensive Care Unit; and Cheng Hang, BD, is Head of Nursing, Department of Nursing. Acknowledgment: The funding of this project comes from the Research and Development Funding of Kangda College of Nanjing Medical University (Project No.: KD2017KYJJZD019). The authors have disclosed no other financial relationships related to this article. Submitted February 5, 2020; accepted in revised form June 19, 2020.

出版信息

Adv Skin Wound Care. 2021 Mar 1;34(3):144-148. doi: 10.1097/01.ASW.0000732896.29121.06.

DOI:10.1097/01.ASW.0000732896.29121.06

PMID:33587475

Abstract

OBJECTIVE

To investigate the characteristics and risk factors of endotracheal intubation-related pressure injury (EIRPI) in patients admitted to the ICU and provide a basis for EIRPI prevention and treatment.

METHODS

A total of 156 patients with endotracheal intubation who were admitted to ICU at a first-class hospital from January to December 2018 were enrolled in this study. Investigators collected and analyzed data and outcomes such as patient characteristics (demographic and clinical), endotracheal catheter-related factors, and the assessment and features of pressure injuries.

RESULTS

The incidence of EIRPI was 23.7%. The most commonly affected site was the lip (76.7%). The incidence was affected by endotracheal intubation types, endotracheal catheter indwelling time, subglottic suction, catheter fixation, and fixator types (P < .05). In addition, the moisture, mobility, and friction/shear Braden subscale scores were also correlated with the incidence of pressure injury (P < .05). Long endotracheal catheter indwelling time, the use of catheters with subglottic suction, high Braden moisture subscale score, low Braden mobility subscale score, and low Braden friction and shear subscale scores were predictive factors for EIRPI (P < .05).

CONCLUSIONS

Patients in the ICU are at higher risk of developing EIRPI. Early identification of risk factors and timely intervention are the keys to preventing EIRPI.

摘要

目的

探讨 ICU 患者气管插管相关压力性损伤（EIRPI）的特点和危险因素，为 EIRPI 的防治提供依据。

方法

选取 2018 年 1 月至 12 月在某三甲医院 ICU 住院的 156 例气管插管患者，收集并分析患者一般资料（人口学及临床资料）、气管导管相关因素、压力性损伤评估及特点等数据和结局。

结果

EIRPI 发生率为 23.7%，最常发生的部位为唇（76.7%）。EIRPI 的发生与气管插管类型、气管导管留置时间、声门下吸引、导管固定及固定器类型有关（P<0.05），且潮气量、移动度、摩擦力/剪切力的 Braden 亚量表评分与 EIRPI 发生率有关（P<0.05）。气管导管留置时间长、使用带声门下吸引的导管、潮气量 Braden 亚量表评分高、移动度 Braden 亚量表评分低、摩擦力/剪切力 Braden 亚量表评分低是 EIRPI 的预测因素（P<0.05）。