For a study, researchers sought to assess the risk variables for the use of vasopressors and the emergence of hospital-acquired pressure injuries (HAPIs).
In a 12-bed medical ICU at a community hospital, investigators performed a retrospective chart analysis. Between January 2017 and January 2019, 123 patients who had a minimum of 24 hours of continuous vasopressor therapy were included. Vasopressor dosage and HAPI incidence were the main outcomes evaluated, with a subgroup analysis depending on the type. Secondary outcomes were the number of vasopressors used, the time it took for the injury to occur, the mean arterial pressure, mechanical ventilation, the severity, and the location.
The overall incidence of HAPIs was 20.3%, with a low-dose cohort incidence of 17% and a high-dose cohort incidence of 22.4% (P =.317). The subgroup analysis based on vasopressor type showed no differences. According to the National Pressure Injury Advisory Panel severity staging, injuries to the sacrum and coccyx were the most frequent, with the majority being stage 1 or 2. The incidence of HAPI was not correlated with the use of multiple vasopressors, mechanical ventilation, mean arterial pressure, or the length of vasopressor administration. In the high-dose cohort compared to the low-dose cohort, the documentation of time to harm was considerably shorter (157.58 vs. 330.86 hours, P< .05).
Between the low- and high-dose vasopressor groups, there was no difference in the incidence of HAPIs. The need for frequent monitoring for HAPIs in patients on vasopressors is highlighted by the fact that patients who received larger doses of vasopressors had documented pressure injuries earlier than the low-dose cohort.