Sama Sonu, Abrol Ritika, Dhasmana Renu, Sharma Neha, Khandhuri Sushant, Chauhan Rahul, Dwivedi Prateek
Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Department of Internal Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Indian J Crit Care Med. 2023 Jun;27(6):426-432. doi: 10.5005/jp-journals-10071-24470.
Lack of eyecare protective measures especially in unconscious and sedated critically ill patients, make them prone to ocular surface diseases (OSDs), e.g., exposure keratopathy. This study is aimed to frame an algorithm-based approach to eyecare via eyecare bundle to bring down the burden of OSDs in critically ill patients especially in resource-limited settings.
After clearance from institutional ethical committee, a quasi-experimental single center study was conducted over a period of 6 months. Incidence of exposure keratopathy was calculated before and after induction of eyecare bundle and was compared. Statistical analysis was done using SPSS software v20. of less than 0.05 was considered significant.
A total of 218 patients were enrolled in the study after obtaining informed written consent and after fulfilling inclusion criteria. Patients were divided into control and experimental groups, with baseline characteristics similar in both the groups, respectively, in terms of gender, age (40 years), APACHE II score, and specialty distribution except predominantly medical patients in experimental group. In control group ( = 99), total 69 patients (41 medical and 28 surgical) developed exposure keratopathy, while in experimental group ( = 109) only 15 patients (6 medical and 9 surgical) developed exposure keratopathy, hence a significant reduction was observed. Further follow-up of patients in the experimental group was also done on Days 5 and 7, respectively.
The proposed protocolized algorithm-based eyecare bundle significantly reduced the incidence of exposure keratopathy in sedated, mechanically ventilated, and vulnerable critically ill patients.
Sama S, Abrol R, Dhasmana R, Sharma N, Khandhuri S, Chauhan R, . Effect of Implementation of an Eyecare Bundle on Incidence of Exposure Keratopathy in Intensive Care Unit of Tertiary Care Center in North India. Indian J Crit Care Med 2023;27(6):426-432.
缺乏眼部护理保护措施,尤其是在昏迷和使用镇静剂的重症患者中,使他们容易患上眼表疾病(OSD),例如暴露性角膜病变。本研究旨在构建一种基于算法的眼部护理方法,即通过眼部护理集束措施,以减轻重症患者尤其是资源有限环境下患者的眼表疾病负担。
经机构伦理委员会批准后,进行了为期6个月的单中心准实验研究。计算眼部护理集束措施实施前后暴露性角膜病变的发生率并进行比较。使用SPSS软件v20进行统计分析。P值小于0.05被认为具有统计学意义。
在获得知情书面同意并符合纳入标准后,共有218例患者纳入研究。患者分为对照组和实验组,两组在性别、年龄(40岁)、急性生理与慢性健康状况评分系统II(APACHE II)评分和专科分布方面基线特征相似,但实验组内科患者占比更高。对照组(n = 99)中,共有69例患者(41例内科和28例外科)发生暴露性角膜病变,而实验组(n = 109)中仅有15例患者(6例内科和9例外科)发生暴露性角膜病变,因此观察到显著降低。还分别在第5天和第7天对实验组患者进行了进一步随访。
所提出的基于算法的标准化眼部护理集束措施显著降低了使用镇静剂、机械通气且易患的重症患者暴露性角膜病变的发生率。
萨马S,阿卜罗尔R,达斯马纳R,夏尔马N,坎德胡里S,乔汉R,. 眼部护理集束措施对印度北部三级护理中心重症监护病房暴露性角膜病变发生率的影响。《印度重症医学杂志》2023;27(6):426 - 432。