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Pandemi yoğun bakım ünitelerinde takip edilen Covid-19 hastalarında basınç ülseri gelişimi ve takibinin değerlendirilmesi

Year 2021, Volume: 6 Issue: 2, 86 - 91, 05.05.2021

Halit Baykan

https://doi.org/10.22391/fppc.883135

Abstract

Giriş: Basınç ülseri basınca maruz kalan kemik çıkıntıların olduğu alanlarda oluşur. Görülme sıklığı %1,6-%49 arasındadır. COVID-19 hastalığına bağlı olarak gelişen akciğer yetmezliği nedeniyle hastalar sıklıkla yoğun bakım ünitelerinde takip edilmektedir. Hastaların bir kısmı solunum yetersizliği nedeniyle entübe edilerek ventilatör ile solunum desteği sağlanmaktadır. Uzun süre ventilatör takibi yapılan hastalarda bası yarası gelişme riski artmaktadır. Bu çalışmada Covid-19 hastalarında basınç ülserlerinin sıklığının araştırılması amaçlanmıştır.

Yöntem: Kayseri Şehir Eğitim ve Araştırma Hastanesinde Mart-Kasım 2020 arasında Covid-19 yoğun bakım (YB) ünitelerinde takip edilen ve bası ülseri gelişen hastalar çalışmaya alındı. Hastaların verileri geriye doğru tarandı, bilgisayar ve dosyalardan elde edilen veriler değerlendirilerek çalışmaya alındı.


: Yoğun bakımlarda toplam 4922 hasta takip edildi, 2010 hasta entübe edildi ve 1332 hasta ex oldu. Sadece 51 hastada çeşitli evrelerde basınç ülseri görüldü.

Sonuç: Çalışmamızdan üç önemli sonuç çıkarılmıştır. Birincisi, basınç ülserleri Covid-19’lu hastalarda, çoğunlukla yaşlı ve altta yatan kronik hastalığı bulunan kişilerde görülmektedir. İkincisi, basınç ülserleri Covid-19 hastalarında, Covid-19 dışı hastalara göre daha az görülmektedir. Üçüncüsü, Yoğun bakım ünitelerinde hemşirelik bakımı oldukça önemlidir.

Keywords

Yoğun Bakım Ünitesi Basınç ülseri Covid

References

  • 1. Defloor T, Schoonhoven L, Fletcher J, Furtado K, Heyman HW, Lubbers MJ, et al. Statement of the European Pressure Ulcer Advisory Panel-Pressure Ulcer Classification: Differentiation Between Pressure Ulcers and Moisture Lesions. J Wocn. 2005;32(5):302–6. https://doi.org/10.1097/00152192-200509000-00006
  • 2. Cox J. Predictors of pressure ulcers in adult critical care patients. Am J Crit care. 2011;20(5):364–75. https://doi.org/10.4037/ajcc2011934
  • 3. Karahan A, Abbasoğlu A, Işık SA, Çevik B, Saltan Ç, Elbaş NÖ, et al. Factors Affecting Wound Healing in Individuals With Pressure Ulcers: A Retrospective Study. Ostomy Wound Manage. 2018;64(2):32–9. https://pubmed.ncbi.nlm.nih.gov/29481325/
  • 4. Shahin ESM, Dassen T, Halfens RJG. Pressure ulcer prevalence in intensive care patients: a cross‐sectional study. J Eval Clin Pract. 2008;14(4):563–8. https://doi.org/10.1111/j.1365-2753.2007.00918.x
  • 5. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470–3. https://doi.org/10.1016/S0140-6736(20)30185-9
  • 6. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. 2020;323(13):1239–42. https://doi.org/10.1001/jama.2020.2648
  • 7. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–20. https://doi.org/10.1056/NEJMoa2002032
  • 8. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061–9. https://doi.org/10.1001/jama.2020.1585
  • 9. Liu X, Zhou H, Zhou Y, Wu X, Zhao Y, Lu Y, et al. Risk factors associated with disease severity and length of hospital stay in COVID-19 patients. J Infect. 2020;81(1):e95–7. https://doi.org/10.1016/j.jinf.2020.04.008
  • 10. Phua J, Weng L, Ling L, Egi M, Lim C-M, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506–17. https://doi.org/10.1016/S2213-2600(20)30161-2
  • 11. Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. Intubation and ventilation amid the COVID-19 outbreak: Wuhan’s experience. Anesthesiology. 2020;132(6):1317–32. https://doi.org/10.1097/ALN.0000000000003296
  • 12. Terekeci H, Kucukardali Y, Top C, Onem Y, Celik S, Öktenli Ç. Risk assessment study of the pressure ulcers in intensive care unit patients. Eur J Intern Med. 2009;20(4):394–7. https://doi.org/10.1016/j.ejim.2008.11.001
  • 13. Herman LE, Rothman KF. Prevention, care, and treatment of pressure (decubitus) ulcers in intensive care unit patients. J Intensive Care Med. 1989;4(3):117–23. https://doi.org/10.1177/088506668900400306
  • 14. Yarkony GM. Pressure ulcers: a review. Arch Phys Med Rehabil. 1994;75(8):908–17. https://doi.org/10.1016/0003-9993(94)90117-1
  • 15. Witkowski JA, Parish LC. Debridement of cutaneous ulcers: medical and surgical aspects. Clin Dermatol. 1991;9(4):585–91. https://doi.org/10.1016/0738-081X(91)90088-3
  • 16. Baxter CR, Rodeheaver GT. Interventions: hemostasis, cleansing, topical antibiotics, debridement and closure. In: Eaglstein WH, editor. New directions in wound healing. Princeton, NJ: ER Squibb & Sons, Inc.; 1990. p. 71–82.

Evaluation of pressure ulcer development and follow-up in Covid-19 patients followed in pandemic intensive care units

Year 2021, Volume: 6 Issue: 2, 86 - 91, 05.05.2021

Halit Baykan

https://doi.org/10.22391/fppc.883135

Abstract

Introduction: Pressure ulcers occur in areas with bony protrusions exposed to pressure. Its incidence is between 1.6% and 49%. Due to respiratory failure in Covid-19, patients are frequently followed up in intensive care units. Some of the patients are intubated, and respiratory support is provided with a ventilator. The risk of developing pressure sores increases in patients followed for a long time on a ventilator. This study was conducted to investigate the frequency of pressure ulcers in Covid-19 patients.

Methods: Patients followed up in Covid-19 intensive care (ICU) units in Kayseri City Training and Research Hospital between March and November 2020 and developed pressure ulcers were included in the study. Patient data were collected retrospectively using electronic health records.

Results: A total of 4922 patients were followed up in intensive care units, 2010 patients were intubated, and 1332 patients died. Only 51 patients had pressure ulcers at various stages.

Conclusion: Pressure ulcers in Covid-19 patients are seen mainly in the elderly and people with underlying chronic diseases. Besides, the probability of pressure ulcers in this group was less than in other patients. Furthermore, nursing care is critical in intensive care units.

Keywords

Intensive care unit Pressure ulcer Covid

References

  • 1. Defloor T, Schoonhoven L, Fletcher J, Furtado K, Heyman HW, Lubbers MJ, et al. Statement of the European Pressure Ulcer Advisory Panel-Pressure Ulcer Classification: Differentiation Between Pressure Ulcers and Moisture Lesions. J Wocn. 2005;32(5):302–6. https://doi.org/10.1097/00152192-200509000-00006
  • 2. Cox J. Predictors of pressure ulcers in adult critical care patients. Am J Crit care. 2011;20(5):364–75. https://doi.org/10.4037/ajcc2011934
  • 3. Karahan A, Abbasoğlu A, Işık SA, Çevik B, Saltan Ç, Elbaş NÖ, et al. Factors Affecting Wound Healing in Individuals With Pressure Ulcers: A Retrospective Study. Ostomy Wound Manage. 2018;64(2):32–9. https://pubmed.ncbi.nlm.nih.gov/29481325/
  • 4. Shahin ESM, Dassen T, Halfens RJG. Pressure ulcer prevalence in intensive care patients: a cross‐sectional study. J Eval Clin Pract. 2008;14(4):563–8. https://doi.org/10.1111/j.1365-2753.2007.00918.x
  • 5. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470–3. https://doi.org/10.1016/S0140-6736(20)30185-9
  • 6. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. 2020;323(13):1239–42. https://doi.org/10.1001/jama.2020.2648
  • 7. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–20. https://doi.org/10.1056/NEJMoa2002032
  • 8. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061–9. https://doi.org/10.1001/jama.2020.1585
  • 9. Liu X, Zhou H, Zhou Y, Wu X, Zhao Y, Lu Y, et al. Risk factors associated with disease severity and length of hospital stay in COVID-19 patients. J Infect. 2020;81(1):e95–7. https://doi.org/10.1016/j.jinf.2020.04.008
  • 10. Phua J, Weng L, Ling L, Egi M, Lim C-M, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506–17. https://doi.org/10.1016/S2213-2600(20)30161-2
  • 11. Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. Intubation and ventilation amid the COVID-19 outbreak: Wuhan’s experience. Anesthesiology. 2020;132(6):1317–32. https://doi.org/10.1097/ALN.0000000000003296
  • 12. Terekeci H, Kucukardali Y, Top C, Onem Y, Celik S, Öktenli Ç. Risk assessment study of the pressure ulcers in intensive care unit patients. Eur J Intern Med. 2009;20(4):394–7. https://doi.org/10.1016/j.ejim.2008.11.001
  • 13. Herman LE, Rothman KF. Prevention, care, and treatment of pressure (decubitus) ulcers in intensive care unit patients. J Intensive Care Med. 1989;4(3):117–23. https://doi.org/10.1177/088506668900400306
  • 14. Yarkony GM. Pressure ulcers: a review. Arch Phys Med Rehabil. 1994;75(8):908–17. https://doi.org/10.1016/0003-9993(94)90117-1
  • 15. Witkowski JA, Parish LC. Debridement of cutaneous ulcers: medical and surgical aspects. Clin Dermatol. 1991;9(4):585–91. https://doi.org/10.1016/0738-081X(91)90088-3
  • 16. Baxter CR, Rodeheaver GT. Interventions: hemostasis, cleansing, topical antibiotics, debridement and closure. In: Eaglstein WH, editor. New directions in wound healing. Princeton, NJ: ER Squibb & Sons, Inc.; 1990. p. 71–82.
There are 16 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Original Research
Authors

Halit Baykan 0000-0002-3352-3946

Publication Date May 5, 2021
Submission Date February 19, 2021
Acceptance Date May 3, 2021
Published in Issue Year 2021 Volume: 6 Issue: 2

Cite

APA Baykan, H. (2021). Evaluation of pressure ulcer development and follow-up in Covid-19 patients followed in pandemic intensive care units. Family Practice and Palliative Care, 6(2), 86-91. https://doi.org/10.22391/fppc.883135
AMA Baykan H. Evaluation of pressure ulcer development and follow-up in Covid-19 patients followed in pandemic intensive care units. Fam Pract Palliat Care. May 2021;6(2):86-91. doi:10.22391/fppc.883135
Chicago Baykan, Halit. “Evaluation of Pressure Ulcer Development and Follow-up in Covid-19 Patients Followed in Pandemic Intensive Care Units”. Family Practice and Palliative Care 6, no. 2 (May 2021): 86-91. https://doi.org/10.22391/fppc.883135.
EndNote Baykan H (May 1, 2021) Evaluation of pressure ulcer development and follow-up in Covid-19 patients followed in pandemic intensive care units. Family Practice and Palliative Care 6 2 86–91.
IEEE H. Baykan, “Evaluation of pressure ulcer development and follow-up in Covid-19 patients followed in pandemic intensive care units”, Fam Pract Palliat Care, vol. 6, no. 2, pp. 86–91, 2021, doi: 10.22391/fppc.883135.
ISNAD Baykan, Halit. “Evaluation of Pressure Ulcer Development and Follow-up in Covid-19 Patients Followed in Pandemic Intensive Care Units”. Family Practice and Palliative Care 6/2 (May2021), 86-91. https://doi.org/10.22391/fppc.883135.
JAMA Baykan H. Evaluation of pressure ulcer development and follow-up in Covid-19 patients followed in pandemic intensive care units. Fam Pract Palliat Care. 2021;6:86–91.
MLA Baykan, Halit. “Evaluation of Pressure Ulcer Development and Follow-up in Covid-19 Patients Followed in Pandemic Intensive Care Units”. Family Practice and Palliative Care, vol. 6, no. 2, 2021, pp. 86-91, doi:10.22391/fppc.883135.
Vancouver Baykan H. Evaluation of pressure ulcer development and follow-up in Covid-19 patients followed in pandemic intensive care units. Fam Pract Palliat Care. 2021;6(2):86-91.

Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505