For a study, researchers sought to investigate trends and risk factors for pressure injuries (PIs) in adult critical care patients who were being treated for acute respiratory distress syndrome caused by COVID-19, as well as to evaluate the effectiveness of products and tactics utilized to prevent PIs. Between April 9 and June 8, 2020, the authors did a retrospective chart review. Descriptive statistics were used to evaluate demographic data. The differences between the groups with and without PIs were investigated.
Male sex (P=.019), high body mass index (>40 kg/m2; P=.020), low Braden Scale score (12; P=.018), and low-dose vasopressor medication (P=.020) were significant PI risk factors among 147 patients. Endotracheal tube (ETT) taping resulted in considerably fewer face PIs than commercial ETT holders (P<.0001). Maximum prone duration/session was a significant risk factor for anterior PIs (P=.016), and it was reduced by 71% with newer pressure redistribution solutions. Greater than 3,200 μg/mL of d-Dimer (P=.042) was found to be a significant risk factor for sacrococcygeal PIs when supine. Mortality was 30%; significant risk factors included being over 60 years old (P=.005), having a Sequential Organ Failure Assessment score greater than 11 (P=.003), and having concomitant congestive heart failure (P=.016).
Taping the ETT, restricting the maximum length of prone positioning to less than 32 hours, and often shifting when supine might lower the number of modifiable risk factors for PIs. Standardized methodologies will inform individualized patient management for testing items for PI prevention.