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Incidencia de lesiones por presión en pacientes con y sin Covid-19, ingresados en una unidad de cuidados intensivos
Resumen
Objetivo: Comparar la incidencia de lesiones por presión (LPP) en los pacientes ingresados en una Unidad de Cuidados Intensivos (UCI) durante los tres primeros meses desde el inicio de la pandemia por COVID-19, con el mismo período del año anterior.
Diseño: Estudio de cohorte histórica.
Discusión y conclusiones:
La incidencia de LPP en UCI ha sido muy superior en los tres meses desde el inicio de la pandemia por COVID-19.
La media móvil del Índice COMHON es útil para estimar si el paciente crítico está protegido ante las LPP.
Recomendamos estudiar los factores que están relacionados con la incidencia encontrada.
ABSTRACT
Objetive: To compare the incidence of pressure injuries (PI) in patients admitted to an Intensive Care Unit (ICU) during the first three months since the onset of the COVID-19 pandemic with the same period of the previous year.
Design: Historical cohort study.
Discussion and conclusions:
The incidence of PI in ICU has been much higher in the three months since the onset of the COVID-19 pandemic.
The COMHON Index moving average is useful for estimating whether the critical patient with COVID-19 is protected against PI.
We recommend studying the factors that are related to the incidence found.
Palabras clave
Citas
BIBLIOGRAFÍA
World Health Organization. Alocución de apertura del Director General de la OMS en la rueda de prensa sobre la COVID-19 [Internet]. 2020 [citado 30 marzo 2020]. Disponible en: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol [Internet]. 2020 [cited 2020 Aug 27]; 5 (7):802-10. DOI:10.1001 / jamacardio.2020.0950
Equipo COVID-19. RENAVE. CNE. CNM (ISCIII). Informe nº 33. Análisis de los casos de COVID-19 notificados a la RENAVE hasta el 10 de mayo en España a 29 de mayo de 2020. [Internet]. 2020 [citado 29 mayo 2020]. Disponible en: https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE/EnfermedadesTransmisibles/Paginas/InformesCOVID-19.aspx
Ballesteros Sanz MA, Hernández-Tejedor A, Estella A, Jiménez Rivera JJ, González de Molina Ortiz FJ, Sandiumenge Camps A, et al. Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los grupos de trabajo de la sociedad española de medicina intensiva, crítica y unidades coronarias (SEMICYUC). Med Intensiva [Internet]. 2020 [citado 27 agosto 2020]; 44 (6): 371-88. DOI:10.1016/j.medin.2020.04.001
Coiras M, Serrano S, Plaza JA, Molina P, Álvarez D. Manifestaciones clínicas de la enfermedad COVID-19. En Alcamí Pertejo J (coord.). Informes científicos COVID-19. [Internet]. Madrid: Instituto de Salud Carlos III; 2020. [citado 16 junio 2020]: 93-100. Disponible en: http://gesdoc.isciii.es/gesdoccontroller?action=download&id=15/01/2021-874dbb1eec
Phua J, Weng L, Ling L, Egi M, Lim C, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): Challenges and recommendations. Lancet Respir Med [Internet]. 2020 [cited 2020 Aug 27]; 8 (5): 506-17. DOI:10.1016/S2213-2600(20)30161-2
Coiras M, Meijón Ortigueira MM, Jiménez Yuste V. Problemas de inmunocoagulación y trombos en pacientes con COVID-19. En Alcamí Pertejo J (coord.). Informes científicos COVID-19. [Internet]. Madrid: Instituto de Salud Carlos III; 2020. [citado 16 junio 2020]:110-114. Disponible en: http://gesdoc.isciii.es/gesdoccontroller?action=download&id=15/01/2021-874dbb1eec
Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: A review. JAMA Cardiol [Internet]. 2020 [cited 2020 Aug 27]; 5 (7):831-840. DOI:10.1001/jamacardio.2020.1286
Giannis D, Ziogas IA, Gianni P. Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past. J Clin Virol [Internet]. 2020 06 [cited 2020 Aug 27]; 127: 104362. DOI:10.1016/j.jcv.2020.104362
Han H, Yang L, Liu R, Liu F, Kai-lang Wu, Li J, et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clinical Chemistry and Laboratory Medicine (CCLM) [Internet]. 2020 [cited 2020 May 23]; 58 (7):1116-20. DOI:10.1515/cclm-2020-0188
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost [Internet]. 2020 [cited 2020 Aug 27]; 18 (4): 844-7. DOI:10.1111/jth.14768
Chong PY, Chui P, Ling AE, Franks TJ, Tai DYH, Leo YS, et al. Analysis of deaths during the severe acute respiratory syndrome (SARS) epidemic in Singapore: Challenges in determining a SARS diagnosis. Arch Pathol Lab Med [Internet]. 2004 [cited 2020 Aug 27]; 128 (2): 195-204. DOI:10.1043/1543-2165(2004)1282.0.CO;2
Galván Casas C, Català A, Carretero Hernández G, Rodríguez‐Jiménez P, Fernández‐Nieto D, Rodríguez-Villa Lario A, et al. Classification of the cutaneous manifestations of COVID-19: A rapid prospective nationwide consensus study in Spain with 375 cases. British J. Dermatol [Internet]. 2020 [cited 2020 Aug 27]; 183 (1): 71-7. DOI:10.1111/bjd.19163
Pérez-Suárez B, Martínez-Menchón T, Cutillas-Marco E. Hallazgos cutáneos en la pandemia de COVID-19 en la región de Murcia. Med Clin (Barc) [Internet]. 2020 [citado 27 agosto 2020]; 155 (1): 41-2. DOI:10.1016/j.medcli.2020.05.001
Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med [Internet]. 2020 [cited 2020 Sep 2]; 46 (5): 854-87. DOI:10.1007/s00134-020-06022-5
Edsberg L, Black J, Goldberg M, Mcnichol L, Moore L, Seiggreen M. Revised national pressure ulcer advisory panel pressure injury staging system revised pressure injury staging system. J Wound Ostomy Continence Nurs [Internet]. 2016 [cited 2020 Aug 27]: 43 (6): 585-597. DOI:10.1097/WON.0000000000000281
Cox J. Pressure injury risk factors in adult critical care patients: A review of the literature. Wound manag. amp; prev [Internet]. 2017 [citado 27 agosto 2020]; 63 (11): 30-43. Available from: https://www.hmpgloballearningnetwork.com/site/wmp/article/pressure-injury-risk-factors-adult-critical-care-patients-review-literature.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med [Internet]. 1985 [cited 2020 Aug 27]; 13 (10): 818-29. DOI:10.1097/00003246-198510000-00009
Alderden J, Rondinelli J, Pepper G, Cummins M, Whitney J. Risk factors for pressure injuries among critical care patients: A systematic review. Int J Nurs Stud [Internet]. 2017 [cited 2020 Aug 27]; 71: 97-114. DOI:10.1016/j.ijnurstu.2017.03.012
Cox J, Roche S, Murphy V. Pressure injury risk factors in critical care patients: A descriptive analysis. Adv Skin Wound Care [Internet]. 2018 [cited 2020 Aug 27]; 31 (7): 328-34. DOI:10.1097/01.ASW.0000534699.50162.4e
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 [Internet]. 2016 [cited 2020 Aug 27]; 13 (5): 912-9. DOI:10.1111/iwj.12406
Nowicki JL, Mullany D, Spooner A, Nowicki TA, Mckay PM, Corley A, et al. Are pressure injuries related to skin failure in critically ill patients? Aust Crit Care [Internet]. 2018 [cited 2020 Aug 27]; 31 (5): 257-63. DOI:10.1016/j.aucc.2017.07.004
Coleman S, Nixon J, Keen J, Wilson L, McGinnis E, Dealey C, et al. A new pressure ulcer conceptual framework. J Adv Nurs [Internet]. 2014 [cited 2020 Aug 27]; 70 (10): 2222-34. DOI:10.1111/jan.12405
Fulbrook P, Anderson A. Pressure injury risk assessment in intensive care: Comparison of inter-rater reliability of the COMHON (conscious level, mobility, haemodynamics, oxygenation, nutrition) index with three scales. J Adv Nurs [Internet]. 2016 [cited 2020 Aug 27]; 72 (3): 680-92. DOI:10.1111/jan.12825
González-Méndez MI, Lima-Serrano M, Martín-Castaño C, Alonso-Araujo I, Lima-Rodríguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs [Internet]. 2018 [cited 2020 Jul18]; 27 (5-6): 1028-37. DOI:10.1111/jocn.14091
Pittman J, Beeson T, Terry C, Dillon J, Hampton C, Kerley D, et al. Unavoidable pressure ulcers: Development and testing of the Indiana university health pressure ulcer prevention inventory. J Wound Ostomy Continence Nurs [Internet]. 2016 [cited 2020 Aug 24]; 43 (1): 32–38. DOI:10.1097/WON.0000000000000191
Byrne J, Nichols P, Sroczynski M, Stelmaski L, Stetzer M, Line C, et al. Prophylactic sacral dressing for pressure ulcer prevention in high-risk patients. Am J Crit Care [Internet]. 2016 [cited 2020 Aug 27]; 25 (3): 228-34. DOI:10.4037/ajcc2016979
Black JM, Edsberg LE, Baharestani MM, Langemo D, Goldberg M, McNichol L, et al. Pressure ulcers: Avoidable or unavoidable? Results of the National Pressure Ulcer Advisory Panel Consensus Conference. Ostomy Wound Manage [Internet]. 2011 [cited 2020 Aug 21]; 57 (2): 24-37. Available from: https://europepmc.org/article/med/21350270
Webb-Anderson K, Daley P, Isenor C, McMullen S, Kelly E, Bishop L. Intensive Care Unit (ICU) pressure injury prevention: When ‘under pressure’, use evidence to inform action! Dynamics of Critical Care 2018, Calgary, Alberta Canada, sept 24-25th 2018. Can J Crit Care Nurs [Internet]. 2018 [cited 2020 Aug 23]; 29 (2): 60-1. Available from: https://www.caccn.ca/files/CJCCN/29-2-2018%20CJCCN.pdf
Del Castillo Otero D, Cortés Caballero A, García Cuesta A, De la Cruz Castro NP. Ventilación mecánica no invasiva (VNI) en pacientes agudos y crónicos. En Soto Campos JG. Manual de diagnóstico y terapéutica en neumología 3ª Ed. Madrid: ERGON; 2016 [Internet]. [citado 28 agosto 2020]. Disponible en: https://www.neumosur.net/files/publicaciones/ebook/14-VNI-Neumologia-3_ed.pdf
Moore Z, Patton D, Avsar P, McEvoy NL, Curley G, Budri A, et al. Prevention of pressure ulcers among individuals cared for in the prone position: Lessons for the COVID-19 emergency. J Wound Care [Internet]. 2020 [cited 2020 Aug 27]; 29 (6): 312-20. DOI:10.12968/jowc.2020.29.6.312
Schmitt S, Andries MK, Ashmore PM, Brunette G, Judge K, Bonham PA. WOCN society position paper: Avoidable versus unavoidable pressure ulcers/injuries. J Wound Ostomy Continence Nurs [Internet]. 2017 [cited 2020 Aug 21]; 44 (5): 458–468. DOI:10.1097/WON.0000000000000361
Tian Y, Rong L, Nian W, He Y. Review article: Gastrointestinal features in COVID-19 and the possibility of faecal transmission. Aliment Pharmacol Ther [Internet]. 2020 [cited 2020 Aug 13]; 51 (9): 843-51. DOI:10.1111/apt.15731
Edsberg LE, Langemo D, Baharestani MM, Posthauer ME, Goldberg M. Unavoidable pressure injury: State of the science and consensus outcomes. J Wound Ostomy Continence Nurs [Internet]. 2014 [cited 2020 Aug 21]; 41 (4): 313–334. DOI:10.1097/WON.0000000000000050
Leal-Felipe MA, Arroyo-López MC, Robayna-Delgado MC, Gómez-Espejo A, Perera-Díaz P, Chinea-Rodríguez CD, et al. Predictive ability of the EVARUCI scale and COMHON index for pressure injury risk in critically ill patients: A diagnostic accuracy study. Aust Crit Care. [Internet]. 2018 [cited 2020 Jul 25]; 31 (6): 355-61. DOI:10.1016/j.aucc.2017.11.003
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. Haesler, Emily ed. EPUAP/NPIAP/PPPIA; [Internet]. 2019 [cited 2020 Aug 23]. Available from: https://internationalguideline.com
Lovegrove J, Fulbrook P, Miles S. International consensus on pressure injury preventative interventions by risk level for critically ill patients: A modified delphi study. Int Wound J [Internet]. 2020 [cited 2020 Aug 24]; n/a (n/a). DOI:10.1111/iwj.13461
Harmsen SM, Chang YH, Hattrup SJ. Simple moving average: A method of reporting evolving complication rates. Orthopedics. [Internet] .2016 [cited 2020 Aug 25]; 39 (5): e869-76. DOI:10.3928/01477447-20160517-02
Grupo de desarrollo Índice COMHON. Diseño y estudio de la validez y fiabilidad de una nueva escala de valoración del riesgo de úlceras por presión en UCI. Índice COMHON. Evidentia [Internet]. 2013 [citado 27 agosto 2020]; 10 (42): 16p. Disponible en: http://www.index-f.com/evidentia/n42/ev8013.php
Torra-Bou JE. Incidencia de úlceras por presión en unidades de cuidados intensivos. Revisión sistemática con meta-análisis [Tesis Doctoral]. Alicante: Universitat d'Alacant - Universidad de Alicante; 2016
Azuh O, Gammon H, Burmeister C, Frega D, Nerenz D, DiGiovine B, et al. Benefits of early active mobility in the medical intensive care unit: A pilot study. Am J Med. [Internet]. 2016 [cited 2020 Aug 25]; 129 (8): 866. DOI:10.1016/j.amjmed.2016.03.032
González Méndez, MI. Incidencia y factores de riesgo para el desarrollo de úlceras por presión en la Unidad de cuidados intensivos del Hospital Universitario Virgen del Rocío [Tesis Doctoral]. Sevilla: Universidad de Sevilla; 2016
Gulati A, Pomeranz C, Qamar Z, Thomas S, Frisch D, George G, et al. A comprehensive review of manifestations of novel coronaviruses in the context of deadly COVID-19 global pandemic. Am J Med Sci [Internet]. 2020 [cited 2020 Sep 24]; 360 (1): 5-34. DOI:10.1016/j.amjms.2020.05.006
Babamohamadi H, Ansari Z, Nobahar M, Mirmohammadkhani M. The effects of peppermint gel on prevention of pressure injury in hospitalized patients with head trauma in neurosurgical ICU: A double-blind randomized controlled trial. Complement Ther Med [Internet]. 2019 [cited 2020 Sep 24]; 47: 102223. DOI:10.1016/j.ctim.2019.102223
Becker D, Tozo TC, Batista SS, Mattos AL, Silva MCB, Rigon S, et al. Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil. Intensive Crit Care Nurs [Internet]. 2017 [cited 2020 Aug 25]; 42: 55-61. DOI:10.1016/j.iccn.2017.03.009
Keller BP, Wille J, Van Ramshorst B, Van der Werken C. Pressure ulcers in intensive care patients: A review of risks and prevention. Intensive Care Med [Internet]. 2002 [cited 2020 Aug 23]; 28 (10): 1379-88. DOI:10.1007/s00134-002-1487-z
Kaitani T, Tokunaga K, Matsui N, Sanada H. Risk factors related to the development of pressure ulcers in the critical care setting. J Clin Nurs [Internet]. 2010 [cited 2020 Aug 25]; 19 (3-4): 414-21. DOI:10.1111/j.1365-2702.2009.03047.x
Alderden J, Rondinelli J, Pepper G, Cummins M, Whitney J. Risk factors for pressure injuries among critical care patients: A systematic review. Int J Nurs Stud [Internet]. 2017 [cited 2020 Aug 27]. 97-114. DOI: 10.1016/j.ijnurstu.2017.03.012
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