Ribeiro Ranya Nascimento, Oliveira Daniel Vieira de, Paiva Wellingson S, Sousa Regina Marcia C, Vieira Rita de Cassia A
Nursing Department, Federal University of Sergipe, Lagarto, Brazil.
Department of Medicine, Federal University of Sergipe, Lagarto, Brazil.
BMJ Open. 2024 Dec 15;14(12):e089243. doi: 10.1136/bmjopen-2024-089243.
Patients with moderate and severe traumatic brain injury (TBI) admitted to the intensive care unit (ICU) may develop pressure injury (PI) due to haemodynamic instability caused by the disease, lack of mobility in bed, as well as intense and prolonged compression in prominent bone areas.
The objective of this review is to assess the incidence and identify risk factor for the development of PI in patients with moderate and severe TBI admitted to the ICU.
Searches were conducted in the PubMed, CINAHL, Scopus, Embase, Web of Science, Google Scholar, Trove and Open Grey databases, including all records found up to May 2023. Patients with moderate and severe TBI admitted to the ICU were included in this review.
A total of 368 studies on PI and TBI were identified in the databases. Two authors assessed study bias and extracted data, wit. h a third reviewer as arbitrator. Six studies met the inclusion and exclusion criteria in the review. The incidence of PI varied between 6.5% and 20% among the included studies. Only two studies applied the Braden Scale, which identified stage II lesions (52.6% and 51.5%), located in the sacral region (78.9% and 54.6%). The risk factors identified in the studies for the development of PI were mechanical ventilation, TBI severity, vasoactive drugs, age, fever, use of enteral nutrition, haemoglobin levels and time to perform tracheostomy.
The incidence of PI in moderate and severe patients was similar to that found in ICU patients. There were significant differences across the various studies in the ways in which data were collected and reported.
The protocol has been deposited in the PROSPERO repository (CRD42023428817).
入住重症监护病房（ICU）的中重度创伤性脑损伤（TBI）患者，可能因疾病导致的血流动力学不稳定、卧床缺乏活动能力以及突出骨部位的强烈和长时间压迫而发生压疮（PI）。
本综述的目的是评估入住ICU的中重度TBI患者发生PI的发生率并确定其危险因素。
在PubMed、CINAHL、Scopus、Embase、Web of Science、谷歌学术、Trove和Open Grey数据库中进行检索，包括截至2023年5月找到的所有记录。本综述纳入入住ICU的中重度TBI患者。
数据库中总共识别出368项关于PI和TBI的研究。两名作者评估研究偏倚并提取数据，第三名审阅者作为仲裁人。六项研究符合本综述的纳入和排除标准。纳入研究中PI的发生率在6.5%至20%之间。只有两项研究应用了Braden量表，该量表识别出II期损伤（52.6%和51.5%），位于骶骨区域（78.9%和54.6%）。研究中确定的PI发生的危险因素为机械通气、TBI严重程度、血管活性药物、年龄、发热、肠内营养的使用、血红蛋白水平和气管切开时间。
中重度患者PI的发生率与ICU患者相似。各项研究在数据收集和报告方式上存在显著差异。
该方案已存入PROSPERO储存库（CRD42023428817）。
