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Medical Device-Related Pressure Injuries in Intensive Care Patiens

Yıl 2025, Cilt: 29 Sayı: 3, 253 - 264, 25.12.2025
https://doi.org/10.62111/ybhd.1672749

Öz

This systematic review was conducted to examine pressure injuries due to medical devices in intensive care patients and the measures taken to prevent these pressure injuries. Relevant studies on the subject were screened retrospectively. 10 keywords were used for screening. Various combinations of these words were used and six international databases were screened between September 1-30, 2021. 1479 studies were attained and examined. 20 descriptive, cross-sectional and randomized controlled studies in English abstracts, which have reported pressure injuries due to medical devices in adult intensive care patients and in the general patient population including adult intensive care patients, were included in the study. For this systematic review, the authors conducted a comprehensive search through scientific databases with relevant keywords; and they evaluated and summarized the results. The method of the study, sample characteristics and data on pressure injuries due to medical devices were examined in each study. When the studies included in the review were examined, it was seen that the prevalence of pressure injuries due to medical devices was high. Studies have also found that many risk factors such as low Braden score, use of more than one medical device, longer use of medical devices, sedation, enteral nutrition and duration of mechanical ventilation increase the risk of pressure injury due to medical devices. The varying high prevalence of pressure injuries due to medical devices indicates the need for evidence-based preventive measures and risk diagnosis.

Kaynakça

  • 1. Gefen A, Alves P, Ciprandi G, et al. Device-related pressure ulcers: SECURE prevention. J Wound Care. 2020;29(Sup2a):1-52.
  • 2. Jackson D, Sarki AM, Betteridge R, Brooke J. Medical device-related pressure ulcers: A systematic review and meta-analysis. Int J Nurs Stud. 2019;92:109-120.
  • 3. Coyer FM, Stotts NA, Blackman VS. A prospective window into medical device-related pressure ulcers in intensive care. Int Wound J. 2014;11(6):656-664.
  • 4. Cavalcanti EdO, Kamada I. Medical-device-related pressure injury on adults: An integrative review. Text & Context Nursing. 2020;29:e20180371.
  • 5. Cooper KL. Evidence-based prevention of pressure ulcers in the intensive care unit. Crit Care Nurse. 2013;33(6):57-66.
  • 6. Barakat-Johnson M, Lai M, Wand T, Li M, White K, Coyer F. The incidence and prevalence of medical device-related pressure ulcers in intensive care: A systematic review. J Wound Care. 2019;28(8):512-521.
  • 7. Black JM, Cuddigan JE, Walko MA, Didier LA, Lander MJ, Kelpe MR. Medical device related pressure ulcers in hospitalized patients. Int Wound J. 2010;7(5):358-365.
  • 8. Dang W, Liu Y, Zhou Q, et al. Risk factors of medical device-related pressure injury in intensive care units. J Clin Nurs. 2022;31(9-10):1174-1183.
  • 9. Camacho-Del Rio G. Evidence-based practice: Medical device–related pressure injury prevention. Am Nurse Today. 2018;3(10):50-52.
  • 10. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.
  • 11. Padula CA, Paradis H, Goodwin R, Lynch J, Hegerich-Bartula D. Prevention of medical device-related pressure ınjuries associated with respiratory equipment use in a critical care unit: a quality ımprovement project. J Wound Ostomy Continence Nurs. 2017;44(2):138-141.
  • 12. Arundel L, Irani E, Barkema G. Reducing the ıncidence of medical device-related pressure ınjuries from use of CPAP/BiPAP masks: A quality ımprovement project. J Wound Ostomy Continence Nurs. 2021;48(2):108-114.
  • 13. Cao S, Gu M, Feng M, et al. Implementation of evidence in preventing medical device-related pressure injury in ICU patients using the i-PARIHS framework. J Nurs Manag. 2022;30(1):318-327.
  • 14. Hanönü, S, Karadağ A. A prospective, descriptive study to determine the rate and characteristics of and risk factors for the development of medical device-related pressure ulcers in intensive care units. Ostomy Wound Manage. 2016;62(2):12-22.
  • 15. Hampson J, Green C, Stewart J, et al. Impact of the introduction of an endotracheal tube attachment device on the incidence and severity of oral pressure injuries in the intensive care unit: A retrospective observational study. BMC Nurs. 2018;8;17:4.
  • 16. Kim CH, Kim MS, Kang MJ, Kim HH, Park NJ, Jung HK. Oral mucosa pressure ulcers in intensive care unit patients: A preliminary observational study of incidence and risk factors. J Tissue Viability. 2019;28(1):27-34.
  • 17. Mehta C, Ali M, Mehta Y, George JV, Singh MK. MDRPU-an uncommonly recognized common problem in ICU: A point prevalence study. J Tissue Viability. 2019;28(1):35-39.
  • 18. Choi BK, Kim MS, Kim SH. Risk prediction models for the development of oral-mucosal pressure injuries in intubated patients in intensive care units: A prospective observational study. J Tissue Viability. 2020;29(4):252-257.
  • 19. Coyer F, Cook JL, Brown W, Vann A, Doubrovsky A. Securement to prevent device-related pressure injuries in the intensive care unit: A randomised controlled feasibility study. Int Wound J. 2020;17(6):1566-1577.
  • 20. Kuniavsky M, Vilenchik E, Lubanetz A. Under (less) pressure- Facial pressure ulcer development in ventilated ICU patients: A prospective comparative study comparing two types of endotracheal tube fixations. Intensive Crit Care Nurs. 2020;58:102804.
  • 21. Binda F, Galazzi A, Marelli F, et al. Complications of prone positioning in patients with COVID-19: A cross-sectional study. Intensive Crit Care Nurs. 2021;67:103088.
  • 22. Coyer F, Barakat-Johnson M, Campbell J, et al. Device-related pressure injuries in adult intensive care unit patients: An Australian and New Zealand point prevalence study. Aust Crit Care. 2021;34(6):561-568.
  • 23. Galetto SGDS, do Nascimento ERP, Hermida PMV, Busanello J, de Malfussi LBH, Lazzari DD. Medical device-related pressure injuries in critical patients: Prevalence and associated factors. Rev Esc Enferm USP 2021;55:e20200397.
  • 24. Qin L, Yun W, Hang C. Risk Factors of endotracheal ıntubation-related pressure injury among patients admitted to the ICU. Adv Skin Wound Care. 2021;34(3):144-148.
  • 25. Shapira-Galitz Y, Karp G, Cohen O, Halperin D, Lahav Y, Adi N. Evaluation and predictors for nasogastric tube associated pressure ulcers in critically ill patients. Isr Med Assoc J. 2018;20(12):731-736.
  • 26. Tayyib N, Coyer F, Lewis P. Saudi Arabian adult intensive care unit pressure ulcer incidence and risk factors: a prospective cohort study. Int Wound J. 2016;13(5):912-919.
  • 27. Hobson DB, Chang TY, Aboagye JK, et al. Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units. J Crit Care. 2017;40:1-6.
  • 28. Bubun J, Yusuf S, Darwis M. Relationship between skin moisture and medical device related pressure injury (MDRPI) in intensive care units: Prospective study. Enfermería Clínica. 2020;30:420-423.
  • 29. Zhou Q, Yu T, Liu Y, et al. The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study. J Clin Nurs. 2018;27(3-4):694-704.
  • 30. Bader DL, Worsley PR, Gefen A. Bioengineering considerations in the prevention of medical device-related pressure ulcers. Clin Biomech (Bristol, Avon). 2019;67:70-77.

Yoğun Bakım Hastalarında Tıbbi Araçlara Bağlı Basınç Yaralanmaları

Yıl 2025, Cilt: 29 Sayı: 3, 253 - 264, 25.12.2025
https://doi.org/10.62111/ybhd.1672749

Öz

Bu sistematik derleme yoğun bakım hastalarında tıbbi araçlara bağlı gelişen basınç yaralanmalarını ve bu basınç yaralanmalarını önlemek için alınan önlemleri incelemek amacıyla yapıldı. Konuyla ilgili çalışmalar retrospektif olarak tarandı. Tarama için 10 anahtar kelime kullanıldı. Bu kelimelerin çeşitli kombinasyonları denenerek uluslararası altı veri tabanında 01-30 Eylül 2021 tarihleri arasında tarama yapıldı. Ulaşılan 1479 çalışma incelendi. Yetişkin yoğun bakım hastalarında tıbbi araçlara bağlı basınç yaralanmalarını ve yetişkin yoğun bakım hastalarının da dahil olduğu genel hasta popülasyonunda tıbbi araçlara bağlı basınç yaralanmalarını bildiren, İngilizce veya İngilizce özeti olan Türkçe tanımlayıcı, kesitsel araştırmalar ve randomize kontrollü olan 20 çalışma araştırmaya dahil edildi. Bu sistematik inceleme için yazarlar, ilgili anahtar kelimelerle bilimsel veri tabanlarında kapsamlı bir araştırma yapmış ve sonuçları değerlendirip özetlemişlerdir. Her çalışmada; çalışmanın yöntemi, örneklem özellikleri, tıbbi araçlara bağlı basınç yaralanmaları verileri incelenmiştir. Araştırma kapsamına alınan çalışmalar incelendiğinde tıbbi araçlara bağlı basınç yaralanması prevalansının yüksek olduğu görülmüştür. Çalışmalarda düşük Braden skoru, birden fazla tıbbi araç kullanımı, daha uzun süre tıbbi araç kullanımı, sedasyon, enteral beslenme, mekanik ventilasyon süresi gibi birçok risk faktörünün tıbbi araçlara bağlı basınç yaralanması riskini arttırdığı saptanmıştır. Tıbbi araçlara bağlı basınç yaralanmalarının prevalansının değişen oranlarda yüksek olması, kanıta dayalı önleyici tedbirlere ve risk tanılamaya ihtiyaç olduğunu göstermektedir.

Etik Beyan

Çalışmalara veri tabanlarından ulaşıldığı için etik izin alınmadı.

Kaynakça

  • 1. Gefen A, Alves P, Ciprandi G, et al. Device-related pressure ulcers: SECURE prevention. J Wound Care. 2020;29(Sup2a):1-52.
  • 2. Jackson D, Sarki AM, Betteridge R, Brooke J. Medical device-related pressure ulcers: A systematic review and meta-analysis. Int J Nurs Stud. 2019;92:109-120.
  • 3. Coyer FM, Stotts NA, Blackman VS. A prospective window into medical device-related pressure ulcers in intensive care. Int Wound J. 2014;11(6):656-664.
  • 4. Cavalcanti EdO, Kamada I. Medical-device-related pressure injury on adults: An integrative review. Text & Context Nursing. 2020;29:e20180371.
  • 5. Cooper KL. Evidence-based prevention of pressure ulcers in the intensive care unit. Crit Care Nurse. 2013;33(6):57-66.
  • 6. Barakat-Johnson M, Lai M, Wand T, Li M, White K, Coyer F. The incidence and prevalence of medical device-related pressure ulcers in intensive care: A systematic review. J Wound Care. 2019;28(8):512-521.
  • 7. Black JM, Cuddigan JE, Walko MA, Didier LA, Lander MJ, Kelpe MR. Medical device related pressure ulcers in hospitalized patients. Int Wound J. 2010;7(5):358-365.
  • 8. Dang W, Liu Y, Zhou Q, et al. Risk factors of medical device-related pressure injury in intensive care units. J Clin Nurs. 2022;31(9-10):1174-1183.
  • 9. Camacho-Del Rio G. Evidence-based practice: Medical device–related pressure injury prevention. Am Nurse Today. 2018;3(10):50-52.
  • 10. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.
  • 11. Padula CA, Paradis H, Goodwin R, Lynch J, Hegerich-Bartula D. Prevention of medical device-related pressure ınjuries associated with respiratory equipment use in a critical care unit: a quality ımprovement project. J Wound Ostomy Continence Nurs. 2017;44(2):138-141.
  • 12. Arundel L, Irani E, Barkema G. Reducing the ıncidence of medical device-related pressure ınjuries from use of CPAP/BiPAP masks: A quality ımprovement project. J Wound Ostomy Continence Nurs. 2021;48(2):108-114.
  • 13. Cao S, Gu M, Feng M, et al. Implementation of evidence in preventing medical device-related pressure injury in ICU patients using the i-PARIHS framework. J Nurs Manag. 2022;30(1):318-327.
  • 14. Hanönü, S, Karadağ A. A prospective, descriptive study to determine the rate and characteristics of and risk factors for the development of medical device-related pressure ulcers in intensive care units. Ostomy Wound Manage. 2016;62(2):12-22.
  • 15. Hampson J, Green C, Stewart J, et al. Impact of the introduction of an endotracheal tube attachment device on the incidence and severity of oral pressure injuries in the intensive care unit: A retrospective observational study. BMC Nurs. 2018;8;17:4.
  • 16. Kim CH, Kim MS, Kang MJ, Kim HH, Park NJ, Jung HK. Oral mucosa pressure ulcers in intensive care unit patients: A preliminary observational study of incidence and risk factors. J Tissue Viability. 2019;28(1):27-34.
  • 17. Mehta C, Ali M, Mehta Y, George JV, Singh MK. MDRPU-an uncommonly recognized common problem in ICU: A point prevalence study. J Tissue Viability. 2019;28(1):35-39.
  • 18. Choi BK, Kim MS, Kim SH. Risk prediction models for the development of oral-mucosal pressure injuries in intubated patients in intensive care units: A prospective observational study. J Tissue Viability. 2020;29(4):252-257.
  • 19. Coyer F, Cook JL, Brown W, Vann A, Doubrovsky A. Securement to prevent device-related pressure injuries in the intensive care unit: A randomised controlled feasibility study. Int Wound J. 2020;17(6):1566-1577.
  • 20. Kuniavsky M, Vilenchik E, Lubanetz A. Under (less) pressure- Facial pressure ulcer development in ventilated ICU patients: A prospective comparative study comparing two types of endotracheal tube fixations. Intensive Crit Care Nurs. 2020;58:102804.
  • 21. Binda F, Galazzi A, Marelli F, et al. Complications of prone positioning in patients with COVID-19: A cross-sectional study. Intensive Crit Care Nurs. 2021;67:103088.
  • 22. Coyer F, Barakat-Johnson M, Campbell J, et al. Device-related pressure injuries in adult intensive care unit patients: An Australian and New Zealand point prevalence study. Aust Crit Care. 2021;34(6):561-568.
  • 23. Galetto SGDS, do Nascimento ERP, Hermida PMV, Busanello J, de Malfussi LBH, Lazzari DD. Medical device-related pressure injuries in critical patients: Prevalence and associated factors. Rev Esc Enferm USP 2021;55:e20200397.
  • 24. Qin L, Yun W, Hang C. Risk Factors of endotracheal ıntubation-related pressure injury among patients admitted to the ICU. Adv Skin Wound Care. 2021;34(3):144-148.
  • 25. Shapira-Galitz Y, Karp G, Cohen O, Halperin D, Lahav Y, Adi N. Evaluation and predictors for nasogastric tube associated pressure ulcers in critically ill patients. Isr Med Assoc J. 2018;20(12):731-736.
  • 26. Tayyib N, Coyer F, Lewis P. Saudi Arabian adult intensive care unit pressure ulcer incidence and risk factors: a prospective cohort study. Int Wound J. 2016;13(5):912-919.
  • 27. Hobson DB, Chang TY, Aboagye JK, et al. Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units. J Crit Care. 2017;40:1-6.
  • 28. Bubun J, Yusuf S, Darwis M. Relationship between skin moisture and medical device related pressure injury (MDRPI) in intensive care units: Prospective study. Enfermería Clínica. 2020;30:420-423.
  • 29. Zhou Q, Yu T, Liu Y, et al. The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study. J Clin Nurs. 2018;27(3-4):694-704.
  • 30. Bader DL, Worsley PR, Gefen A. Bioengineering considerations in the prevention of medical device-related pressure ulcers. Clin Biomech (Bristol, Avon). 2019;67:70-77.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Yoğun Bakım Hemşireliği
Bölüm Derleme
Yazarlar

Bilge Tezcan 0000-0003-0896-128X

Şule Alpar Ecevit 0000-0003-0951-0106

Gönderilme Tarihi 9 Nisan 2025
Kabul Tarihi 24 Mayıs 2025
Yayımlanma Tarihi 25 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 29 Sayı: 3

Kaynak Göster

Bu derginin içeriği Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı kapsamında lisanslanmıştır.

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