Department of Clinical Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland.
Department of Anesthesiology and Intensive Therapy, University Hospital in Krakow, 31-688 Krakow, Poland.
Int J Environ Res Public Health. 2021 Oct 25;18(21):11178. doi: 10.3390/ijerph182111178.
In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients' severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient's evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro-Wilk test, the Spearman's rank correlation test, the Mann-Whitney U test and the Friedman's ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos ( < 0.001), sedation ( 0.01), use of some cardiological drugs and antibiotics ( < 0.01), mechanical ventilation ( < 0.05), use of an open suctioning system ( < 0.01), presence of injuries ( < 0.01) including craniofacial trauma ( 0.001), high level of care intensity ( < 0.01), failure to follow eye care protocol ( 0.001), length of hospitalization at the ICU ( 0.001), and the frequency of ophthalmological consultations ( 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors.
在危重症患者中,正常的眼部保护机制,如泪液产生、眨眼和闭眼,会受到损害。此外,许多与患者严重病情和治疗相关的其他因素也会导致眼表疾病。减少危险因素和适当的眼部护理对降低眼部并发症的发生率和患者从重症监护病房(ICU)出院后的生活质量有重大影响。本研究旨在确定眼部并发症的危险因素,特别是与护理相关的危险因素。该研究在一所大学医院的 ICU 进行。使用了估计和分析病历的方法。制定了涵盖 12 类眼部并发症危险因素的患者评估表。研究组包括 76 名患者(34 名受伤患者和 42 名未受伤患者)。使用 Shapiro-Wilk 检验、Spearman 秩相关检验、Mann-Whitney U 检验和 Friedman ANOVA 检验。显著性水平设定为 α=0.05。研究组中眼部并发症的最重要危险因素是:眼睑闭合不全(<0.001)、镇静(0.01)、使用某些心血管药物和抗生素(<0.01)、机械通气(<0.05)、使用开放式抽吸系统(<0.01)、存在损伤(<0.01)包括头面部创伤(0.001)、高护理强度水平(<0.01)、未遵循眼部护理方案(<0.001)、在 ICU 的住院时间(<0.001)和眼科会诊频率(<0.001)。这些并发症的发生率与患者的年龄和性别之间没有相关性。危重症患者眼部并发症的暴露率很高。有必要传播 ICU 患者眼部护理的方案和指南,以降低危险因素。