Tissue interface pressure and skin integrity in critically ill, mechanically ventilated patients.
Tissue interface pressure and skin integrity in critically ill, mechanically ventilated patients.
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DOI：
10.1016/j.iccn.2016.07.004
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发表时间：
2017-03
影响因子：
5.3
通讯作者：
Lucas V
中科院分区：
文献类型：
--
作者：
Grap MJ;Munro CL;Wetzel PA;Schubert CM;Pepperl A;Burk RS;Lucas V
描述组织界面压力、高于临界压力水平的时间以及对7个解剖位置皮肤完整性的影响。在中大西洋城市大学医学中心的外科创伤ICU-STICU、医学呼吸ICU-MRICU、神经科学ICU-NSICU中对重症机械通气成人进行的描述性纵向研究。受试者在插管后24小时内入组研究。使用Xcampus压力标测系统（Xcampus Technology Corporation，Calgary，Canada）连续测量组织界面压力。在ICU的前7天以及第10天和第14天，使用国家压疮咨询小组分期系统，每天两次观察所有部位的皮肤完整性。在132例受试者中，90.9%的受试者未观察到皮肤完整性变化。骶骨、左转子和右转子的最大界面压力几乎100%在32 mmHg以上。在45 mmHg水平，左侧和右侧转子在该水平以上的时间最长（超过95%的时间），其次是骶骨、左侧和右侧肩胛骨以及左侧和右侧脚跟。同样，在高于60 mmHg的水平下，应用相同的部位顺序。对于发生骶骨皮肤完整性变化的6名受试者，最大压力100%时间大于32 mmHg。与整个样本相比，6个骶骨变化中的4个与高于45 mmHg和60 mmHg的时间更长相关。在大多数记录的时间段内，最大组织界面压力高于临界水平，特别是在骶骨，尽管记录了皮肤完整性的一些变化。与最大压力相比，平均压力高于临界水平的时间要少得多。最大压力可能反映了压力峰值，但高于临界压力水平的大量时间仍然很长。
To describe tissue interface pressure, time spent above critical pressure levels and the effect on skin integrity at seven anatomical locations. Descriptive, longitudinal study in critically ill mechanically ventilated adults, from Surgical Trauma ICU-STICU; Medical Respiratory ICU-MRICU; Neuroscience ICU-NSICU in a Mid-Atlantic urban university medical centre. Subjects were enroled in the study within 24 hours of intubation. Tissue interface pressure was measured continuously using the XSENSOR pressure mapping system (XSENSOR Technology Corporation, Calgary, Canada). Skin integrity was observed at all sites, twice daily, using the National Pressure Ulcer Advisory Panel staging system, for the first seven ICU days and at day 10 and 14. Of the 132 subjects, 90.9% had no observed changes in skin integrity. Maximum interface pressure was above 32 mmHg virtually 100% of the time for the sacrum, left and right trochanter. At the 45 mmHg level, the left and right trochanter had the greatest amount of time above this level (greater than 95% of the time), followed by the sacrum, left and right scapula, and the left and right heels. Similarly, at levels above 60 mmHg, the same site order applied. For those six subjects with sacral skin integrity changes, maximum pressures were greater than 32 mmHg100% of the time. Four of the six sacral changes were associated with greater amounts of time above both 45 mmHg and 60 mmHg than the entire sample. Maximum tissue interface pressure was above critical levels for the majority of the documented periods, especially in the sacrum, although few changes in skin integrity were documented. Time spent above critical levels for mean pressures were considerably less compared to maximum pressures. Maximum pressures may have reflected pressure spikes, but the large amount of time above the critical pressure levels remains substantial.
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影响因子：
2.8
作者：
Burk, Ruth Srednicki;Grap, Mary Jo
通讯作者：
Grap, Mary Jo
影响因子：
3.6
作者：
Aoi, Noriyuki;Yoshimura, Kotaro;Sanada, Hiromi
通讯作者：
Sanada, Hiromi
影响因子：
4.2
作者：
Kaitani, Toshiko;Tokunaga, Keiko;Sanada, Hiromi
通讯作者：
Sanada, Hiromi
影响因子：
2.5
作者：
Kottner, J.;Dobos, G.;Blume-Peytavi, U.
通讯作者：
Blume-Peytavi, U.
DOI：
10.1682/jrrd.1990.04.0141
发表时间：
1990-01-01
影响因子：
--
作者：
BADER D L
通讯作者：
BADER D L