Continuous bedside pressure mapping in a general intensive care unit: a prospective observational study. Introduction. A continuous bedside pressure mapping device (PMD) can provide real-time feedback of ideal body position to allow off-loading of high-pressure areas to prevent pressure ulcers development. Objective. To describe the implementation of a PMD to measure tissue interface pressure (PIT) in Intensive Care (ICU) patients. Methods. Prospective observational study in ICU critically ill mechanically ventilated adults, in an Italian University Hospital. Subjects were enrolled in the first 24 hours after ICU admission. A pressure mapping system (M.A.P. System TM) was used and 3 measurements of PIT with patient in supine position, every 6 hours after admission, were performed. The following anti-decubitus surfaces were used: Duo2® - Hill-Rom, Proficare®, Nimbus 3® or Therakair Visio® - Arjohuntleigh, Getinge Group. Results. 27 patients (8 females) were enrolled; average Body Mass Index 27±6 (range: 16-43); 4 patients (14%) were diabetic. The average pressure of the 1215 areas analyzed was 26.7±19.6 mmHg (range: 3-78); the region with the highest contact pressure was the dorsal region (average: 48.7±12.5 mmHg), followed by the occipital (44.7±19.6 mmHg), and sacrum (44.7±10.7 mmHg). The three anti-decubitus surfaces showed different performances in the distribution of PITs, with statistically significant differences for the following factors: body weight (p = 0.017), patient height (p = 0.034), with increased pressures in taller patients, and higher BMI (p <0.0001). Conclusions. Mean values of PIT were above critical levels, especially in the dorsal, occipital and sacrum region.
Un dispositivo di mappatura continua della pressione di interfaccia tissutale (PIT) può fornire un feedback in tempo reale della posizione da far assumere al paziente per consentire lo scarico delle aree ad alta pressione. Obiettivo. Descrivere i risultati di un sistema di mappatura continua della PIT nei pazienti in terapia intensiva. Metodi. Studio osservazionale prospettico su pazienti adulti ventilati meccanicamente, in una terapia intensiva generale di un ospedale universitario italiano nelle prime 24 ore dopo l'ammissione, utilizzando un sistema di mappatura della pressione (M.A.P. System TM). Nelle prime 24 ore sono state eseguite tre valutazioni ad intervalli di 6 ore, della PIT con il paziente in posizione supina, utilizzando le quattro superfici antidecubito disponibili (Duo2® - Hill-Rom, Proficare®, Nimbus 3® Therakair Visio® - Arjohuntleigh, Getinge Group). Risultati. Sono stati inclusi 27 pazienti (8 femmine), età media 61.2±15.3 anni, indice di massa corporea media di 27±6 (range: 16-43); quattro pazienti erano diabetici. Sono state analizzate 1215 aree di PIT. La pressione media è stata di 26.7±19.6 mmHg (intervallo: 3-78). La regione con la più alta pressione di contatto era quella dorsale (media: 48.7±12.5 mmHg), seguita dall'occipitale (44.7±19.6 mmHg) e dall'osso sacro (44.7±10.7 mmHg). Le tre superfici antidecubito hanno avuto prestazioni significativamente differenti nella distribuzione delle PIT per peso corporeo (p=0.017), altezza (p=0.034), con aumento delle pressioni nei pazienti più alti, e BMI più elevati (p<0.0001). Conclusioni. I valori medi di PIT sono stati superiori ai livelli critici durante il periodo di studio, specialmente nella regione dorsale, occipitale e sacrale.
Lucchini, A., Bambi, S., Elli, S., Tuccio, S., La Marca, M., Meduri, D., et al. (2020). Continuous bedside pressure mapping in a gene-ral intensive care unit: A prospective observational study [Monitoraggio continuo delle pressioni di contatto in una terapia intensiva generale: Uno studio prospettico osservazionale]. ASSISTENZA INFERMIERISTICA E RICERCA, 39(1), 5-12 [10.1702/3371.33471].
Continuous bedside pressure mapping in a gene-ral intensive care unit: A prospective observational study [Monitoraggio continuo delle pressioni di contatto in una terapia intensiva generale: Uno studio prospettico osservazionale]
Lucchini, Alberto;Elli, Stefano;
2020
Abstract
Continuous bedside pressure mapping in a general intensive care unit: a prospective observational study. Introduction. A continuous bedside pressure mapping device (PMD) can provide real-time feedback of ideal body position to allow off-loading of high-pressure areas to prevent pressure ulcers development. Objective. To describe the implementation of a PMD to measure tissue interface pressure (PIT) in Intensive Care (ICU) patients. Methods. Prospective observational study in ICU critically ill mechanically ventilated adults, in an Italian University Hospital. Subjects were enrolled in the first 24 hours after ICU admission. A pressure mapping system (M.A.P. System TM) was used and 3 measurements of PIT with patient in supine position, every 6 hours after admission, were performed. The following anti-decubitus surfaces were used: Duo2® - Hill-Rom, Proficare®, Nimbus 3® or Therakair Visio® - Arjohuntleigh, Getinge Group. Results. 27 patients (8 females) were enrolled; average Body Mass Index 27±6 (range: 16-43); 4 patients (14%) were diabetic. The average pressure of the 1215 areas analyzed was 26.7±19.6 mmHg (range: 3-78); the region with the highest contact pressure was the dorsal region (average: 48.7±12.5 mmHg), followed by the occipital (44.7±19.6 mmHg), and sacrum (44.7±10.7 mmHg). The three anti-decubitus surfaces showed different performances in the distribution of PITs, with statistically significant differences for the following factors: body weight (p = 0.017), patient height (p = 0.034), with increased pressures in taller patients, and higher BMI (p <0.0001). Conclusions. Mean values of PIT were above critical levels, especially in the dorsal, occipital and sacrum region.
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