Pressure ulcer in critical patients affected by Covid-19: prone position protocol
DOI:
https://doi.org/10.9789/2175-5361.rpcfo.v15.12061Keywords:
Coronavirus, Pressure ulcer, Prone position, Intensive care units, Critical careAbstract
Objective: to evaluate the incidence of pressure injury, by location, the risk of development by the Braden scale and the use of protectors, in critical patients in a prone protocol with Covid-19, in a hospital in Belo Horizonte. Method: this is an observational, quantitative, descriptive and prospective study. Data were collected through electronic medical records, in the MV system, and in the AGEIS Nutrition system, during the period between April 12 and August 13, 2021. Results: in the total of 251 analyzed medical records of adult patients, it was evidenced 42.2% had pressure injuries, the most frequent location being zygomatic with 50.9%. Most patients used multilayer foam (92%) and 51.4% of patients were at high risk of injury. Conclusion: the incidence of pressure injuries was 42.2%. The presence of comorbidities and the high risk on the Braden scale may have contributed to the considerable percentage.
Downloads
References
European Pressure Ulcer Advisory Panel/ National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries: clinical practice guideline. [Internet]. 2019 [cited 2021 march 19]. Available from: https://www.biosanas.com.br/uploads/outros/artigos_cientificos/127/956e02196892d7140b9bb3cdf116d13b.pdf.
Ponseti EJ, Millán AV, Chinchilla DO. Analysis of complications of prone position in acute respiratory distress syndrome: Quality standard, incidence and related factors. Enferm. intensiva [Internet]. 2017 [cited 2021 march 19];28(3):125-34. Available from: http://dx.doi.org/10.1016/j.enfi.2016.12.003.
Teixeira C, Rosa RG, Maccari JG, Savi A, Rotta FT. Association between electromyographical findings and intensive care unit mortality among mechanically ventilated acute respiratory distress syndrome patients under profound sedation. Rev. bras. ter. intensiva. [Internet]. 2019 [cited 2021 march 19];31(4):497-503. Available from: https://doi.org/10.5935/0103-507X.20190087.
Martel T, Orgill DP. Medical Device–Related Pressure Injuries During the COVID-19 Pandemic. J. wound ostomy continence nurs. [Internet]. 2020 [cited 2021 march 19];47(5):430-34. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722289/.
Fagundes MCM, Freire NP, Machado MH, Ximenes Neto FRG. Unidades de terapia intensiva no Brasil e a fila única de leitos na pandemia de COVID-19. Enferm. foco [Internet]. 2020 [acesso em 19 de março de 2021];11(Esp.2):23-31. Disponível em: http://revista.cofen.gov.br/index.php/enfermagem/article/view/4152/979.
Binda AG, Galazzi A, Marelli F, Gambazza S, Villa L, Vinci E et al. Complications of prone positioning in patients with COVID-19: A cross-sectional study. Intensive crit. care nurs. [Internet]. 2021 [cited 2022 march 10];67:103088. Available from: https://www.sciencedirect.com/science/article/pii/S096433972100077X.
Sobreira WMO. Evidências científicas acerca das medidas preventivas relacionadas à lesão por pressão em unidade de terapia intensiva. [Especialização em Enfermagem em Terapia Intensiva]. Fortaleza (Brasil): Centro Universitário Fametro; 2020 [acesso em 19 de março de 2021]. Disponível em: http://repositorio.unifametro.edu.br/handle/123456789/468.
Busanello J, Galetto SGS, Harter J, Garcia RP. Otimização dos cuidados intensivos na assistência ao paciente com COVID-19. Enferm. foco [Internet]. 2020 [acesso em 19 de março de 2021];11(Esp.2):32-6. Disponível em: http://revista.cofen.gov.br/index.php/enfermagem/article/view/4072.
Rocha FEV, Moreira FF, Ribeiro DC, Bini ACD. O uso da posição prona em pacientes com diagnóstico de COVID-19: uma revisão sistemática. FisiSenectus [Internet] 2020 [acesso em 19 de março de 2021];8(1):133-42. Disponível em: https://doi.org/10.22298/rfs.2020.v8.n1.5403.
Mota M, Bico I, Marques MC. Decúbito ventral na síndrome de dificuldade respiratória no adulto após infeção por Coronavírus. Rev. port. enf. reab. [Internet]. 2020 [acesso em 19 de março de 2021];3(Sup2):16–22. Disponível em: http://rper.aper.pt/index.php/rper/article/view/75.
Pachá HHP, Faria JIL, Oliveira KA, Beccaria LM. Pressure Ulcer in Intensive Care Units: a case-control study. Rev. bras. enferm. [Internet]. 2018 [cited 2021 march 19];71:3027-34. Available from: https://www.scielo.br/j/reben/a/bSnJL7MzRWKDKQqDqhc5f6t/abstract/?lang=pt.
Borghardt AT, Prado TN, Bicudo SDS, Castro DS, Bringuente MEO. Pressure ulcers in critically ill patients: incidence and associated factors. Rev. bras. enferm. [Internet]. 2016 [cited 2021 march 19];69(3):431-8. Available from: http://dx.doi.org/10.1590/0034-7167.2016690307i.
Mendonça PK, Loureiro MDR, Frota OP, Souza AS. Prevention of pressure injuries: actions prescribed by intensive care unit nurses. Texto & contexto enferm. [Internet]. 2018 [cited 2021 march 19];27(4):e4610017. Available from: https://www.scielo.br/j/tce/a/Z9CwyVqcD8MJqtqhy8gYjMG/?lang=pt.
Ministério da Saúde (Brasil). Resolução nº. 466, de 12 de dezembro de 2012. Aprova diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União 13 jun. 2012; Seção 1. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html.
Shearer SC, Parsa KM, Newark A, Peeasy T, Walsh AR, Fernandez S et al. Facial Pressure Injuries from Prone Positioning in the COVID-19 Era. Laryngoscope. [Internet]. 2021 [cited 2022 march 10];131(7):e2139-42. Available from: https://onlinelibrary.wiley.com/doi/10.1002/lary.29374.
Kastoris A, Iordanou S, Efseviou C, Papastylianou A, Soteriades ES, Palazis L. Clinical characteristics, management, and outcome of the first 19 patients with pneumonia due to the 2019 novel Coronavirus disease treated in an intensive care unit in the Republic of Cyprus. Cureus [Internet]. 2021 [cited 2022 march 10];13(5):e15114. Available from: https://www.cureus.com/articles/54111-clinical-characteristics-management-and-outcome-of-the-first-19-patients-with-pneumonia-due-to-the-2019-novel-coronavirus-disease-treated-in-an-intensive-care-unit-in-the-republic-of-cyprus#references.
Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int. j. infect. dis. [Internet]. 2020 [cited 2022 march 10];94:91-5. Available from: https://www.ijidonline.com/article/S1201-9712(20)30136-3/fulltext.
Perrillat A, Foletti JM, Lacagne AS, Guyot L, Graillon N. Facial pressure ulcers in COVID-19 patients undergoing prone positioning: How to prevent an underestimated epidemic? J. Stomatol. Oral Maxillofac. Surg. [Internet]. 2020 Sep [cited 2022 march 10];121(4):442-4. Available from: https://pubmed.ncbi.nlm.nih.gov/32565264/.
Lovicu E, Faraone A, Fortini A. Admission Braden Scale Score as an early independent predictor of in-hospital mortality among in patients with COVID-19: A retrospective cohort study. Worldviews evid. based nurs. [Internet]. 2021 Oct [cited 2022 march 10];18(5):247-53. Available from: https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12526.
Valencio GA, Martins W. Atuação do enfermeiro na prevenção de lesão por pressão em unidade de terapia intensiva. Boletim de Conjuntura [Internet]. 2021 [acesso em 10 de março de 2022];7(19):92-100. Disponível em: https://revista.ioles.com.br/boca/index.php/revista/article/view/395.
Barros RLM, Araújo JS, Reis AAP, Oliveira RSRQ, Barros BTD, Oliveira VMLP et al. Atuação do enfermeiro na prevenção de lesão por pressão em paciente com COVID-19 na UTI. Research, Society and Development [Internet]. 2021 [acesso em 10 de março de 2022];10(17):e10101724111. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/24111.
Published
Versions
- 2023-07-17 (2)
- 2023-06-05 (1)
How to Cite
Issue
Section
License
Copyright (c) 2023 Revista de Pesquisa Cuidado é Fundamental Online
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
TRANSFER AGREEMENT COPYRIGHT I transfer copyright of the article to the Journal of Care Survey is Fundamental - Online - RPCF, so it is accepted due to electronic publishing. The copyright includes the right to reproduce in whole or in part by any means, distributing that article, including figures, photographs, and any translations. The author can also print and distribute copies of your article, stating that since the rights belong to RPCF. I declare that this manuscript is original and has not been submitted for publication, in whole or in part to other online journals or not, so BMMC in the Annals of scientific events or book chapters.
