Systemic Hemodynamic and Oxygenation Risk Factors for Pressure Ulcer Development in Critical Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/159327
Type:
Presentation
Title:
Systemic Hemodynamic and Oxygenation Risk Factors for Pressure Ulcer Development in Critical Care
Abstract:
Systemic Hemodynamic and Oxygenation Risk Factors for Pressure Ulcer Development in Critical Care
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2005
Author:Cuddigan, Janet, PhD, RN, CWCN
P.I. Institution Name:University of Nebraska Medical Center
Title:Assistant Professor
Contact Address:College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA
Contact Telephone:402-559-6612
Co-Authors:Rita A Frantz, PhD, RN, FAAN, Professor
Purpose: The purpose of this study was to identify systemic blood flow
and oxygenation risk factors for pressure ulcer development in critically
ill patients. Conceptual Framework: The Braden Scale is based on strong
epidemiologic evidence associating deficits in mobility, activity, sensory
perception, moisture, nutrition, and friction & shear with pressure ulcer
development. Evidence associating deficits in systemic blood flow and
oxygenation to pressure ulcers is inconsistent. Subjects: Thirty-five
subjects were selected who were admitted to a critical care unit between
October 1, 2000 and September 24, 2003; had a flow-directed pulmonary
artery (PA) catheter; and were pressure ulcer-free on admission. Method:
This historic cohort study is based on review of existing medical records.
Serial data were collected one day prior to PA catheter insertion, on the
day of insertion and for three days following insertion. Results: Six of
thirty-five subjects developed pressure ulcers for a 17% incidence rate in
this select group. Mean age was 63.29 (+ 10.65) years with no significant
differences between groups. Thirty-four subjects were male. Although mean
Braden scores were lower in those developing pressures ulcers, differences
were not significant. Pressure ulcer positive subjects had significantly
higher APACHE II chronic health points (F=91.43, p=.000), and smoking
pack-year histories (F=-2.92, p=.007). On the day of catheter insertion,
those with pressure ulcers had significantly lower systolic blood pressure
(F=2.70, p=.011), diastolic blood pressure (F=2.08, p=.045) and mean
arterial pressure (F=2.43, p=.021). No significant differences were found
for lowest cardiac index, highest pulmonary artery wedge pressure, highest
systemic vascular resistance or any of the parameters of arterial or mixed
venous blood gas analysis. Conclusions: Those developing pressure ulcers
demonstrated significantly lower systolic, diastolic, and mean arterial
pressures on the day of PA catheter placement and nonsignificant trends of
higher oxygen needs over the course of the study.
This work was supported by a Veterans Affairs postdoctoral fellowship.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSystemic Hemodynamic and Oxygenation Risk Factors for Pressure Ulcer Development in Critical Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159327-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Systemic Hemodynamic and Oxygenation Risk Factors for Pressure Ulcer Development in Critical Care</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cuddigan, Janet, PhD, RN, CWCN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Nebraska Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">College of Nursing, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">402-559-6612</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jcuddiga@unmc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Rita A Frantz, PhD, RN, FAAN, Professor</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this study was to identify systemic blood flow <br/> and oxygenation risk factors for pressure ulcer development in critically <br/> ill patients. Conceptual Framework: The Braden Scale is based on strong <br/> epidemiologic evidence associating deficits in mobility, activity, sensory <br/> perception, moisture, nutrition, and friction &amp; shear with pressure ulcer <br/> development. Evidence associating deficits in systemic blood flow and <br/> oxygenation to pressure ulcers is inconsistent. Subjects: Thirty-five <br/> subjects were selected who were admitted to a critical care unit between <br/> October 1, 2000 and September 24, 2003; had a flow-directed pulmonary <br/> artery (PA) catheter; and were pressure ulcer-free on admission. Method: <br/> This historic cohort study is based on review of existing medical records. <br/> Serial data were collected one day prior to PA catheter insertion, on the <br/> day of insertion and for three days following insertion. Results: Six of <br/> thirty-five subjects developed pressure ulcers for a 17% incidence rate in <br/> this select group. Mean age was 63.29 (+ 10.65) years with no significant <br/> differences between groups. Thirty-four subjects were male. Although mean <br/> Braden scores were lower in those developing pressures ulcers, differences <br/> were not significant. Pressure ulcer positive subjects had significantly <br/> higher APACHE II chronic health points (F=91.43, p=.000), and smoking <br/> pack-year histories (F=-2.92, p=.007). On the day of catheter insertion, <br/> those with pressure ulcers had significantly lower systolic blood pressure <br/> (F=2.70, p=.011), diastolic blood pressure (F=2.08, p=.045) and mean <br/> arterial pressure (F=2.43, p=.021). No significant differences were found <br/> for lowest cardiac index, highest pulmonary artery wedge pressure, highest <br/> systemic vascular resistance or any of the parameters of arterial or mixed <br/> venous blood gas analysis. Conclusions: Those developing pressure ulcers <br/> demonstrated significantly lower systolic, diastolic, and mean arterial <br/> pressures on the day of PA catheter placement and nonsignificant trends of <br/> higher oxygen needs over the course of the study.<br/> This work was supported by a Veterans Affairs postdoctoral fellowship.</td></tr></table>en_GB
dc.date.available2011-10-26T21:54:46Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:54:46Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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