Interface pressure at different degrees of backrest elevation with various types of pressure-redistribution surfaces.

Am J Crit Care

Juliane Lippoldt is a registered nurse, Department of Medicine I, Intensive Care Unit, General Hospital of Vienna, Elisabeth Pernicka is a statistician, Department of Medical Statistics, Medical University of Vienna, and Thomas Staudinger is head physician, Department of Medicine I, Intensive Care Unit, Medical University of Vienna/General Hospital of Vienna, Vienna, Austria.

Published: March 2014

Background: Increased elevation of the head of the bed is linked to a higher risk for sacral pressure ulcers. A semirecumbent position of at least 30° is recommended for the prevention of ventilator-associated pneumonia in patients treated with mechanical ventilation. Therefore, prevention of pressure ulcers and prevention of pneumonia seem to demand contradictory, possibly incompatible, positioning.

Objectives: To measure pressure at the interface between sacral skin and the supporting surface in healthy volunteers at different degrees of upright position with different types of mattresses.

Methods: An open, prospective, randomized crossover trial was conducted with 20 healthy volunteers. Interface pressure was measured by using a pressure mapping device with the participant in a supine position at 0, 10°, 30°, and 45° elevation and in the reverse Trendelenburg position at 10° and 30°. Four types of mattresses were examined: 2 different foam mattresses and 2 air suspension beds, 1 of the latter with low-air-loss technology.

Results: Peak sacral interface pressures increased significantly only at 45° of backrest elevation (P < .001). A mattress system with low-air-loss technology significantly reduced peak interface pressures at all angles (P < .001). The reverse Trendelenburg position led to lower peak pressures for all positions (P = .01).

Conclusions: Backrest elevation up to 30° might be a compromise between the seemingly incompatible demands of skin integrity and the prevention of ventilator-associated pneumonia. The reverse Trendelenburg position and a mattress system with low-air-loss technology could be additional useful tools to help prevent skin breakdown at the sacrum.

Download full-text PDF

Source
http://dx.doi.org/10.4037/ajcc2014670DOI Listing

Publication Analysis

Top Keywords

backrest elevation
12
reverse trendelenburg
12
trendelenburg position
12
interface pressure
8
pressure ulcers
8
prevention ventilator-associated
8
ventilator-associated pneumonia
8
healthy volunteers
8
position 10°
8
10° 30°
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!