Associated factors of facial pressure ulcers in patients under non-invasive ventilation during hospital stay in an intermediate care facilities of a Portuguese hospital

Abstract

Background & Aim: Non-invasive ventilation is a procedure that reduces respiratory stress and improves gas exchange, using a patient-ventilator interface; however, it presents consequences such as the development of facial pressure ulcers. We aim to identify the factors associated with facial pressure ulcers in Intermediate Care Facilities patients submitted to non-invasive ventilation. Methods & Materials: A cross-sectional descriptive and analytic study was performed in an intermediate care facilities, of a Portuguese hospital, from August to October of 2018, the study population consisted of patients hospitalized in this unit, who underwent to non-invasive ventilation. Data were collected through an observational form developed to obtain the information of the entire period of hospitalization of the patient. The software used to analyze the data was IBM SPSS Statistics for Windows, Version 23.0. For the descriptive analysis, absolute and relative frequencies also means and standard deviations were computed. Also, to describe the association between the variables, The point biserial correlation coefficient (rpb) were calculated. For data analysis, a significance level of .05 (α) was used. Results: 14.6% of the individuals developed PU, all in the nasal pyramid. NIV was used for 6.07±3.91 days, and PU developed between the 3rd and the 20th day. It was observed that the presence of PU had a significant positive correlation with the GCS score (rpb=0.390, p=0.012) and a significant negative correlation with the duration of NIV (rpb=-0.438, p=0.004). Dependency level, PU risk, and nutritional risk did not correlate with the development of PU. Conclusion: The pressure ulcers associated with non-invasive ventilation appear to be more frequently developed on the nasal pyramid and between the 3rd and the 20th day. Moreover, the level of consciousness and the time of administration of non-invasive ventilation are associated with the development of pressure ulcers.