Implementation of a risk-stratified intervention bundle to prevent pressure injury in intensive care: A before-after study.

Background: Hospital-acquired pressure injury is an enduring problem in intensive care. Several intensive care-specific pressure injury risk assessment tools have been developed, but to date, only the COMHON Index has been aligned with risk-stratified preventative interventions.

Objectives: The aim of this study was to evaluate the effectiveness of a risk-stratified intervention bundle to reduce pressure injury in intensive care and to assess compliance with bundled interventions.

Predictive validity of a pressure injury risk assessment tool at different time-points in patients admitted to the intensive care unit.

Background: Multiple risk assessment scales are available for predicting the development of pressure injuries (PIs) in patients in the intensive care unit (ICU). Most PI risk assessment tools have been validated at the time of admission; however, another time point during treatment could better reflect clinical changes and therefore, the risk of PIs.

Aim: The study aimed to examine the predictive validity of PI risk assessment scale designed for ICU patients, the conscious level, mobility, haemodynamic, oxygenation and nutrition (COMHON) index, at several time points or intervals during ICU stay.

Incidence of hypophosphataemia after ICU admission in mechanically ventilated patients and its relationship with risk factors for refeeding syndrome.

Objective: To describe the incidence of hypophosphatemia in patients admitted to the ICU who have required mechanical ventilation. To analyze the presence of risk factors and its relationship with nutritional practice.

Design: Prospective observational study.

Assessment of pressure injury risk in intensive care using the COMHON index: An interrater reliability study.

Objectives: To assess the interrater reliability of the COMHON (level of COnciousness, Mobility, Haemodynamics, Oxygenation, Nutrition) Index pressure injury risk assessment tool.

Design: Interrater reliability was tested. Twenty-five intensive care patients were each assessed by five different nurse-raters from a pool of intensive care nurses who were available on the days of assessment.

Family burden after critical illness: the forgotten caregivers.

Objective: To determine the incidence of primary caregiver burden in a cohort of family members of critically ill patients admitted to ICU and to identify risk factors related to its development in both the patient and the family member.

Design: Prospective observational cohort study was conducted for 24 months.

Setting: Hospital Universitario Clínico San Cecilio, Granada.

Gut Microbiota Composition Can Predict Colonization by Multidrug-Resistant Bacteria in SARS-CoV-2 Patients in Intensive Care Unit: A Pilot Study.

The SARS-CoV-2 infection has increased the number of patients entering Intensive Care Unit (ICU) facilities and antibiotic treatments. Concurrently, the multi-drug resistant bacteria (MDRB) colonization index has risen. Considering that most of these bacteria are derived from gut microbiota, the study of its composition is essential.

Accuracy of Modified Blue-Dye Testing in Predicting Dysphagia in Tracheotomized Critically Ill Patients.

(1) Background: Diagnosis of dysphagia in critically ill patients with a tracheostomy is important to avoid aspiration pneumonia. The objective of this study was to analyze the validity of the modified blue-dye test (MBDT) on the diagnosis of dysphagia in these patients; (2) Methods: Comparative diagnostic test accuracy study. Tracheostomized patients admitted to the Intensive Care Unit (ICU) were studied with two tests for dysphagia diagnosis: MBDT and fiberoptic endoscopic evaluation of swallowing (FEES) as the reference standard.

Incidence and risk factors for postintensive care syndrome in a cohort of critically ill patients.

Objective: To determine the incidence of postintensive care syndrome in a cohort of critically ill patients admitted to the intensive care unit and to identify risk factors related to its development in the physical, cognitive and mental health areas.

Methods: This was a prospective observational cohort study developed in the intensive care unit of a university hospital. Patients with intensive care unit stays equal to or longer than one week and the need for mechanical ventilation for more than 3 days, shock or delirium were included in the study.

Compliance with preventive measures recommended by an international study group for pressure injuries in adult critically ill patients.

The objective of this cross-sectional descriptive study is to analyse the degree of compliance with the preventive measures for pressure injuries reported by an International Study Group in a cohort of adult critically ill patients. The level of risk of developing pressure injuries was determined using the Conscious level, Mobility, Hemodynamics, Oxygenation and Nutrition (COMHON) index. According to the level of risk, the preventive measures applied to each patient and scores on the different components of the index were recorded.

Agreement of blood glucose measured with glucose meter in arterial, central venous, and capillary samples in adult critically ill patients.

Background: The measurement of blood glucose in critically ill patients is still performed in many ICUs with glucose meters and capillary samples. Several prevalent factors in these patients affect the accuracy of the results and should be interpreted with caution. A weak recommendation from the Surviving Sepsis Campaign (SSC) suggests the use of arterial blood rather than capillary blood for point of care testing using glucose meters.

The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition.

Critically ill patients have an alteration in the microbiome in which it becomes a disease-promoting pathobiome. It is characterized by lower bacterial diversity, loss of commensal phyla, like Firmicutes and Bacteroidetes, and a domination of pathogens belonging to the Proteobacteria phylum. Although these alterations are multicausal, many of the treatments administered to these patients, like antibiotics, play a significant role.

Efficacy and safety of high-flow nasal cannula oxygen therapy in moderate acute hypercapnic respiratory failure.

Objective: To assess the efficacy and safety of high-flow nasal cannula oxygen therapy in treating moderate hypercapnic respiratory failure in patients who cannot tolerate or have contraindications to noninvasive mechanical ventilation.

Methods: A prospective observational 13-month study involving subjects admitted to an intensive care unit with or developing moderate hypercapnic respiratory failure. Clinical and gas exchange parameters were recorded at regular intervals during the first 24 hours.

Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses.

Purpose: The objective was to compare the effectiveness of repositioning every 2 or 4 h for preventing pressure ulcer development in patients in intensive care unit under mechanical ventilation (MV).

Methods: This was a pragmatic, open-label randomized clinical trial in consecutive patients on an alternating pressure air mattress (APAM) requiring invasive MV for at least 24 h in a university hospital in Spain. Eligible participants were randomly assigned to groups for repositioning every 2 (n = 165) or 4 (n = 164) h.

Hospital-acquired pressure ulcers and risk of hospital mortality in intensive care patients on mechanical ventilation.

Rationale, Aims And Objectives: Pressure ulcers (PUs) are a common and serious complication in critically ill patients. The aim of this study was to evaluate the relationship between the development of a PU and hospital mortality in patients requiring mechanical ventilation (MV) in an intensive care unit (ICU).

Methods: A prospective cohort study was performed over two years in patients requiring MV for ≥ 24 hours in a medical-surgical ICU.

Preventing and managing perioperative pulmonary complications following cardiac surgery.

Purpose Of Review: To provide an update of research findings on the mechanisms underlying respiratory complications after cardiac surgery, especially acute respiratory distress syndrome, transfusion-related lung injury and ventilation-associated pneumonia. The article will review some of the preventive and therapeutic measures that can be implemented to reduce these complications, focusing on the use of protective invasive ventilation and postextubation noninvasive ventilation.

Recent Findings: The development of postoperative pulmonary complications is related to various perioperative factors.

Comparison of alternating pressure mattresses and overlays for prevention of pressure ulcers in ventilated intensive care patients: a quasi-experimental study.

Aim: To compare the effectiveness of alternating pressure air mattresses vs. overlays to prevent pressure ulcers in mechanically ventilated patients in intensive care units.

Background: Pressure ulcers prevention is an important issue in the nursing of critically ill patients.

Postoperative respiratory failure after cardiac surgery: use of noninvasive ventilation.

Objectives: To analyze the use of noninvasive ventilation (NIV) in respiratory failure after extubation in patients after cardiac surgery, the factors associated with respiratory failure, and the need for reintubation.

Design: Retrospective observational study.

Setting: Intensive care unit in a university hospital.

Pressure ulcer incidence and risk factors in ventilated intensive care patients.

Purpose: The aim of this study was to determine the incidence of pressure ulcers (PUs) in ventilated patients in all intensive care units (ICUs) in Granada (Spain) and identify risk factors for their development.

Materials And Methods: A prospective cohort study in 9 medical-surgical ICUs was conducted. Two hundred ninety-nine patients with more than 24 hours on mechanical ventilation (MV) were enrolled during 2 periods in a 5-month study.