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成人住院患者与呼吸设备相关的压力性损伤:综合评价。

Respiratory device-related pressure injuries in hospitalised adults: An integrative review.

机构信息

Stricto Sensu Postgraduate Program in Health Care, Federal University of Triângulo Mineiro, Uberaba, Brazil.

Nursing Undergraduate Course, Federal University of Triângulo Mineiro, Uberaba, Brazil.

出版信息

J Clin Nurs. 2023 Sep;32(17-18):5923-5937. doi: 10.1111/jocn.16717. Epub 2023 Apr 10.

Abstract

OBJECTIVE

To identify the main ventilatory support medical devices related to the occurrence of pressure injuries in hospitalised adults, as well as the most frequent anatomical localisations of these injuries.

METHODS

The Integrative review was registered at Open Science Framework as per DOI 10.17605/OSF.IO/P3NTZ. Two independent reviewers, in May 2022, searched the databases: PubMed, Embase, Cochrane Database of Systematic Reviews, LILACS and CINAHL; no language or publication year restriction. The review question was: What are the ventilatory support medical devices that cause PIs in hospitalised adults more often? The terms for searching the database were: "adult," "noninvasive ventilation," "artificial respiration." and "pressure injury," and their synonyms. This review followed the PRISMA checklist.

RESULTS

The final sample was 21 articles. Oxygen nasal catheters caused up to 40.7% of the pressure injuries by ventilatory support devices identified, all in the ears. Noninvasive mechanical ventilation oronasal masks presented an incidence of pressure injuries of 63.3%. The nasal bridge was the site most affected by this mask. The Set of Holders for Insight® endotracheal tubes was the device that caused the most pressure injuries, with an incidence of 75%, affecting lip commissure. Tracheostomy cannula accounted for 18.2% of the pressure injuries related to ventilatory support devices; all lesions were in the neck.

CONCLUSION

The ventilatory support devices causing pressure injuries and the most affected sites were, respectively, nasal catheters, ears; masks, nasal bridge; endotracheal tubes, lip commissures; tracheostomy cannulas, neck.

RELEVANCE FOR CLINICAL PRACTICE

Knowing which respiratory devices cause pressure injuries more often in hospitalised adults and which anatomical localisations are more likely to be affected is fundamental for adopting preventive measures and reducing the occurrence of this problem.

NO PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution because of the review.

摘要

目的

确定与住院成人压力性损伤相关的主要通气支持医疗设备,以及这些损伤最常见的解剖部位。

方法

本综述于 2022 年 5 月在开放科学框架(Open Science Framework)上以 DOI 10.17605/OSF.IO/P3NTZ 进行了注册。两位独立的审查员对以下数据库进行了搜索:PubMed、Embase、Cochrane 系统评价数据库、LILACS 和 CINAHL;无语言或出版年限限制。检索数据库的术语是:“成人”、“无创通气”、“人工呼吸”和“压力性损伤”及其同义词。本综述遵循 PRISMA 清单。

结果

最终样本为 21 篇文章。通气支持设备中,氧气鼻导管导致的压力性损伤占 40.7%,均发生于耳部。经鼻面罩无创机械通气的压力性损伤发生率为 63.3%。该面罩最易发生损伤的部位是鼻桥。Insight®气管内导管固定器组是导致压力性损伤发生率最高的设备,为 75%,影响唇口角。气管切开套管与通气支持设备相关的压力性损伤占 18.2%;所有损伤均发生于颈部。

结论

导致压力性损伤的通气支持设备和最易受损的部位分别为:鼻导管、耳部;面罩、鼻桥;气管内导管、唇口角;气管切开套管、颈部。

临床意义

了解哪些呼吸设备更容易导致住院成人发生压力性损伤,以及哪些解剖部位更容易受到影响,对于采取预防措施和减少该问题的发生至关重要。

无患者或公众贡献

由于本综述为回顾性研究,因此不存在患者或公众贡献。

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