Effects of Hemodynamic Factors and Oxygenation on the Incidence of Pressure Ulcers in the ICU

Adv Skin Wound Care. 2019 Aug;32(8):359-364. doi: 10.1097/01.ASW.0000553599.20444.f4.

Abstract

Objective: To investigate the roles of hemodynamic factors and oxygenation on the incidence of pressure ulcers in patients in the ICU on mechanical ventilation.

Methods: This prospective analytical cross-sectional study was performed in several ICUs for a period of 8 months in Iran. Researchers checked patients for pressure ulcers on a daily basis. They collected demographic, hemodynamic, and oxygenation data until a pressure ulcer occurred, the patient's artificial airway was removed, the patient died, or the patient was discharged.

Results: From August 2017 to February 2018, a total of 2,581 patients were admitted to the study ICUs; of these, 133 patients were eligible for the study. The results indicated that 41.4% (n = 55) of the patients ended up with pressure ulcers. Investigation of the variables using a Cox regression model showed that, among other variables considered in this study, age, mean arterial pressure, and positive end-expiratory pressure in the mechanical ventilator can contribute to the risk of pressure ulcers.

Conclusions: Providers should pay attention to changes in hemodynamic parameters, especially mean arterial pressure; carefully determine the most appropriate positive end-expiratory pressure for patients connected to mechanical ventilation; and take special care of susceptible groups such as older adults and hospitalized patients to decrease the incidence of pressure ulcers.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Female
  • Hemodynamics*
  • Humans
  • Incidence
  • Intensive Care Units*
  • Iran
  • Male
  • Middle Aged
  • Pressure Ulcer / epidemiology*
  • Pressure Ulcer / pathology
  • Prospective Studies
  • Respiration, Artificial / statistics & numerical data*
  • Risk Assessment