Mucosal membrane pressure injury in intensive care units: A scoping review

Abstract

Aim: To describe published work on the current situation of mucosal membrane pressure injury of patients in the intensive care unit.

Background: Device-related pressure injuries in critically ill patients are mostly focused on skin surface injuries, and less attention is paid to mucosal membrane pressure injury.

Methods: We searched PubMed, Embase, Web of Science, CINAHL, and Cochrane Library from database construction until March 1, 2023. Two researchers independently screened and extracted data.

Results: Eighteen articles met our criteria and were published in 2014-2023. The included studies showed that the incidence of mucosal membrane pressure injury in critically ill patients ranged from 0.83% to 88.2%, and the prevalence ranged from 0.16% to 55.6%. The most frequently reported site of mucosal injury is the oral mucosa, followed by the nasal mucosa. Ten studies used Braden to assess the risk of mucosal membrane pressure injury, and only six studies reported specific stages of mucosal membrane pressure injury. Thirteen studies described 30 risk factors for mucosal membrane pressure injury, with albumin being the most frequently reported risk factor, followed by the vasoconstrictive drugs use. Thirty risk factors were summarized in six aspects: medical device-related factors, disease-related factors, treatment- related factors, physiological and biochemical parameters, demographic-related factors, and microbial colonisation.

Conclusions: The incidence or prevalence of mucosal membrane pressure injury varies widely, and specific risk assessment tools and standardized staging criteria need to be further determined. The risk factors of mucosal membrane pressure injury involve multiple aspects, and some risk factors have only been explored in few studies and need to be further verified, in order to detect the risk group of mucosal membrane pressure injury early and take targeted preventive measures.

Implications for clinical practice: We synthesized the current research status of mucosal membrane pressure injury in critically ill patients, which can provide a valuable reference for the clinical staff to develop preventive and management measures for such patients.

Keywords: ICU; Mucosal membrane pressure injury; Risk factors; Scoping review.