Department of Nursing, Daegu Haany University, Gyeongsangbuk-do, Korea.
Department of Nursing, Asan Medical Center, Seoul, Korea.
Worldviews Evid Based Nurs. 2022 Apr;19(2):94-99. doi: 10.1111/wvn.12570. Epub 2022 Mar 1.
Pressure injury (PI) is a significant health problem among inpatients that affects their health, quality of life, and expenses.
This systematic review aimed to compare effects of alternating pressure air mattresses (APMs) with other types of supporting surfaces as a tool for PI prevention.
The literature published between 2009 and 2020 was searched using the databases PubMed, EMBASE, CINAHL, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses process was followed, including independent study selection and data extraction. Quality appraisal was conducted using the Cochrane Risk of Bias Tool (RoB 2.0).
A total of six randomized controlled trials (RCTs) were analyzed. The incidence of hospital-acquired PIs at stage 1 or higher was reported in the APM group from 0.3% to 25%. In one study, APMs were found to be less effective than static air mattresses (SAMs); in contrast, two studies found no difference. In one study, the APM was reported to be more effective than the viscoelastic foam mattress (VFM). On the contrary, in a more recent study, the APM was reported to be less effective than the VFM, and there was no difference compared with high-specification foam mattresses in another study. Using the RoB 2.0 tool, one study was evaluated at "low risk of bias," another as "some concern," and four as "high risk."
There is insufficient evidence to suggest that APM is more effective in preventing PIs than other supporting surfaces. Evidence to date suggests that APM can be used in patients at risk for PIs. It is important to change position regardless of the type of support surface used. Highly controlled RCTs with low risk of bias are needed to provide strong evidence for identifying the most effective PI prevention support surfaces.
压力性损伤（PI）是住院患者面临的重大健康问题，会影响其健康、生活质量和费用。
本系统评价旨在比较交替式压力气垫（APM）与其他支持表面类型作为预防 PI 的工具的效果。
使用 PubMed、EMBASE、CINAHL 和 Cochrane 数据库，检索 2009 年至 2020 年期间发表的文献。遵循系统评价和荟萃分析的首选报告项目（PRISMA）流程，包括独立的研究选择和数据提取。使用 Cochrane 偏倚风险工具（RoB 2.0）进行质量评估。
共分析了 6 项随机对照试验（RCT）。APM 组报告的医院获得性 PI 1 期或更高期的发生率为 0.3%至 25%。一项研究发现 APM 不如静态空气床垫（SAM）有效；相比之下，两项研究发现无差异。一项研究发现 APM 比粘弹性泡沫床垫（VFM）更有效。相反，在最近的一项研究中，APM 比 VFM 更有效，而在另一项研究中，与高规格泡沫床垫相比，APM 没有差异。使用 RoB 2.0 工具，一项研究被评估为“低风险偏倚”，另一项为“存在一定关注”，四项为“高风险”。
目前尚无足够证据表明 APM 在预防 PI 方面比其他支持表面更有效。迄今为止的证据表明，APM 可用于有 PI 风险的患者。无论使用哪种支持表面，改变体位都很重要。需要进行具有低偏倚风险的高度受控 RCT，以提供识别最有效的 PI 预防支持表面的有力证据。
