Pressure ulcers in critically ill: correlation with Intensive Care conditions

Abstract

Introduction: Critically ill are a special category of patients in need of high standards medical and nursing care. Multiple intrinsic and extrinsic factors that characterize these patients tend to contribute into the development of pressure ulcers. Despite the fact that the implementation of preventive measures seems to inhibit the development of pressure ulcers in a significant percentage, there are often conditions that cannot be surpassed and result to the appearance of unavoidable pressure ulcers. Aim: Study of the factors that contribute to the development of pressure ulcers for the critically ill and the effectiveness of the preventive measures applied in ICU. Method: Information regarding hospitalization data was obtained for all 351 critically ill admitted in an ICU of a regional university hospital during a one year period (May 2021-April 2022). Subsequently, a statistical analysis was performed in order to relate the development of pressure ulcers and intrinsic factors as well as other factors such as medication administered, feeding and preventive measures applied. Results: Incidence of decubitus ulcers was estimated at 23%, first noticed on the 10th day from admission, located in the coccyx at a rate above 50%. Extrinsic factors that seem to contribute to the development of pressure ulcers appear to be the length of ICU stay, the administration of vasoactive drugs and the insufficient caloric and protein coverage through feeding. Use of preventive surfaces, seem to act as a deterrent for pressure ulcer development for the majority of the patients. Most of the pressure ulcers developed during ICU stay, were evaluated as stable or improved during ICU discharge. Conclusions: Improvement of the parameters involved in pressure ulcer development for the critically ill, contribute to the reduction of their occurrence in ICU. Despite the use of advanced pressure reducing surfaces, tissue ischemia may occur even after mild pressure applied. However, high percentage of pressure ulcers could be prevented with appropriate medical care.