Pressure injury is a common postoperative complication of wheelchair users. It has a high incidence rate and can induce sepsis and even death. The fabrics that touch patients’ skin directly have a profound impact on ...Pressure injury is a common postoperative complication of wheelchair users. It has a high incidence rate and can induce sepsis and even death. The fabrics that touch patients’ skin directly have a profound impact on their skin surfaces. This review summarizes the research in the last five years on the relationship between pressure injuries and fabrics. Following the preferred reporting items for systematic reviews and meta-analyses(PRISMA) statement, a systematic literature search is conducted in nine databases, including SCI(Web of Science), IEEE, ASTM, Taylor & Francis, ProQuest, Wiley, SpringerLink, PubMed and SAGE. The research objects, experimental equipment and survey results are investigated in this review, in which twenty-four different textiles and seven different test methodologies are involved. The test methodologies include five kinds of performance tests and two kinds of observational studies. Two studies showed that the particular fabric was helpful to reduce the pressure on the skin surface, and twelve studies revealed that the multi-layer fabric with good air permeability, heat dissipation and moisture dissipation was helpful to prevent pressure injury. This review confirms the correlation between the fabric properties and the occurrence of postoperative pressure injury in wheelchair users. Further experiments are needed to reasonably integrate the fabric characteristics of pressure injury prevention into the mass-produced pressure injury prevention clothes for wheelchair users.展开更多
BACKGROUND Neuromonitoring in medical intensive care units is challenging as most patients are unfit for invasive intracranial pressure(ICP)modalities or unstable to transport for imaging.Ultrasonography-based optic n...BACKGROUND Neuromonitoring in medical intensive care units is challenging as most patients are unfit for invasive intracranial pressure(ICP)modalities or unstable to transport for imaging.Ultrasonography-based optic nerve sheath diameter(ONSD)is an attractive option as it is reliable,repeatable and easily performed at the bedside.It has been sufficiently validated in traumatic brain injury(TBI)to be incorporated into the guidelines.However,currently the data for non-TBI patients is inconsistent for a scientific recommendation to be made.AIM To compile the existing evidence for understanding the scope of ONSD in measuring ICP in adult non-traumatic neuro-critical patients.METHODS PubMed,Google Scholar and research citation analysis databases were searched for studies in adult patients with non-traumatic causes of raised ICP.Studies from 2010 to 2024 in English languages were included.RESULTS We found 37 articles relevant to our search.The cutoff for ONSD in predicting ICP varied from 4.1 to 6.3 mm.Most of the articles used cerebrospinal fluid opening pressure followed by raised ICP on computed tomography/magnetic resonance imaging as the comparator parameter.ONSD was also found to be a reliable outcome measure in cases of acute ischaemic stroke,intracerebral bleeding and intracranial infection.However,ONSD is of doubtful utility in septic metabolic encephalopathy,dysnatremias and aneurysmal subarachnoid haemorrhage.CONCLUSION ONSD is a useful tool for the diagnosis of raised ICP in non-traumatic neuro-critically ill patients and may also have a role in the prognostication of a subset of patients.展开更多
Intra-abdominal hypertension(IAH)and abdominal compartment syndrome are well recognized entities among surgical patients.Nevertheless,a number of prospective and retrospective observational studies have shown that IAH...Intra-abdominal hypertension(IAH)and abdominal compartment syndrome are well recognized entities among surgical patients.Nevertheless,a number of prospective and retrospective observational studies have shown that IAH is prevalent in about half of the critically ill patients in the medical intensive care units(ICU)and has been widely recognized as an independent risk factor for mortality.It is alarming to note that many members of the critical care team in medical ICU are not aware of the consequences of untreated IAH and the delay in making the diagnosis leads to increased morbidity and mortality.Frequently it is underdiagnosed and undertreated in this patient population.Elevated intraabdominal pressure decreases the blood flow to the kidneys and other abdominal viscera and also results in reduced cardiac output and difficulties in ventilating the patient because of increased intrathoracic pressure.When intraabdominal hypertension is not promptly recognized and treated,it leads to abdominal compartment syndrome,multiorgan dysfunction syndrome and death.Large volume fluid resuscitation is very common in medical ICU patients presenting with sepsis,shock and other inflammatory conditions like pancreatitis and it is one of the major risk factors for the development of intra-abdominal hypertension.This article presents an overview of the epidemiology,definitions,risk factors,pathophysiology and management of IAH and abdominal compartment syndrome in critically ill medical ICU patients.展开更多
目的总结俯卧位手术患者预防医疗器械压力性损伤的国内外最佳证据,为手术室制定相关预防措施提供实践标准。方法系统检索BMJ、Up To Date、JBI循证卫生保健中心、加拿大安大略注册护士协会、苏格兰学院间指南网、Cochrane Library、Pub...目的总结俯卧位手术患者预防医疗器械压力性损伤的国内外最佳证据,为手术室制定相关预防措施提供实践标准。方法系统检索BMJ、Up To Date、JBI循证卫生保健中心、加拿大安大略注册护士协会、苏格兰学院间指南网、Cochrane Library、PubMed、Web of science、中国知网(CNKI)、维普(VIP)、万方(Wanfang Data)、SinoMed、伤口造口失禁护理学会、EPIAP等数据库,检索时限为建库至2023年12月,包括实践指南、临床决策、共识、系统评价以及证据总结等。纳入文献的质量评价、证据提取和级别判定由2名研究者分别完成。结果共纳入文献15篇,涵盖5篇指南,1篇临床决策,3篇专家共识,2篇系统评价以及4篇证据总结。从术前评估、防护措施、俯卧位摆放、记录、教育培训5个方面汇总39条证据。结论做好术前风险评估,并且结合俯卧位手术特点对可改变的风险因素进行干预尤为重要。在临床实施过程中,严格按照体位摆放标准进行体位安置,并按实际情况制定适合各医疗机构的预防措施。展开更多
文摘Pressure injury is a common postoperative complication of wheelchair users. It has a high incidence rate and can induce sepsis and even death. The fabrics that touch patients’ skin directly have a profound impact on their skin surfaces. This review summarizes the research in the last five years on the relationship between pressure injuries and fabrics. Following the preferred reporting items for systematic reviews and meta-analyses(PRISMA) statement, a systematic literature search is conducted in nine databases, including SCI(Web of Science), IEEE, ASTM, Taylor & Francis, ProQuest, Wiley, SpringerLink, PubMed and SAGE. The research objects, experimental equipment and survey results are investigated in this review, in which twenty-four different textiles and seven different test methodologies are involved. The test methodologies include five kinds of performance tests and two kinds of observational studies. Two studies showed that the particular fabric was helpful to reduce the pressure on the skin surface, and twelve studies revealed that the multi-layer fabric with good air permeability, heat dissipation and moisture dissipation was helpful to prevent pressure injury. This review confirms the correlation between the fabric properties and the occurrence of postoperative pressure injury in wheelchair users. Further experiments are needed to reasonably integrate the fabric characteristics of pressure injury prevention into the mass-produced pressure injury prevention clothes for wheelchair users.
文摘BACKGROUND Neuromonitoring in medical intensive care units is challenging as most patients are unfit for invasive intracranial pressure(ICP)modalities or unstable to transport for imaging.Ultrasonography-based optic nerve sheath diameter(ONSD)is an attractive option as it is reliable,repeatable and easily performed at the bedside.It has been sufficiently validated in traumatic brain injury(TBI)to be incorporated into the guidelines.However,currently the data for non-TBI patients is inconsistent for a scientific recommendation to be made.AIM To compile the existing evidence for understanding the scope of ONSD in measuring ICP in adult non-traumatic neuro-critical patients.METHODS PubMed,Google Scholar and research citation analysis databases were searched for studies in adult patients with non-traumatic causes of raised ICP.Studies from 2010 to 2024 in English languages were included.RESULTS We found 37 articles relevant to our search.The cutoff for ONSD in predicting ICP varied from 4.1 to 6.3 mm.Most of the articles used cerebrospinal fluid opening pressure followed by raised ICP on computed tomography/magnetic resonance imaging as the comparator parameter.ONSD was also found to be a reliable outcome measure in cases of acute ischaemic stroke,intracerebral bleeding and intracranial infection.However,ONSD is of doubtful utility in septic metabolic encephalopathy,dysnatremias and aneurysmal subarachnoid haemorrhage.CONCLUSION ONSD is a useful tool for the diagnosis of raised ICP in non-traumatic neuro-critically ill patients and may also have a role in the prognostication of a subset of patients.
文摘Intra-abdominal hypertension(IAH)and abdominal compartment syndrome are well recognized entities among surgical patients.Nevertheless,a number of prospective and retrospective observational studies have shown that IAH is prevalent in about half of the critically ill patients in the medical intensive care units(ICU)and has been widely recognized as an independent risk factor for mortality.It is alarming to note that many members of the critical care team in medical ICU are not aware of the consequences of untreated IAH and the delay in making the diagnosis leads to increased morbidity and mortality.Frequently it is underdiagnosed and undertreated in this patient population.Elevated intraabdominal pressure decreases the blood flow to the kidneys and other abdominal viscera and also results in reduced cardiac output and difficulties in ventilating the patient because of increased intrathoracic pressure.When intraabdominal hypertension is not promptly recognized and treated,it leads to abdominal compartment syndrome,multiorgan dysfunction syndrome and death.Large volume fluid resuscitation is very common in medical ICU patients presenting with sepsis,shock and other inflammatory conditions like pancreatitis and it is one of the major risk factors for the development of intra-abdominal hypertension.This article presents an overview of the epidemiology,definitions,risk factors,pathophysiology and management of IAH and abdominal compartment syndrome in critically ill medical ICU patients.
文摘目的总结俯卧位手术患者预防医疗器械压力性损伤的国内外最佳证据,为手术室制定相关预防措施提供实践标准。方法系统检索BMJ、Up To Date、JBI循证卫生保健中心、加拿大安大略注册护士协会、苏格兰学院间指南网、Cochrane Library、PubMed、Web of science、中国知网(CNKI)、维普(VIP)、万方(Wanfang Data)、SinoMed、伤口造口失禁护理学会、EPIAP等数据库,检索时限为建库至2023年12月,包括实践指南、临床决策、共识、系统评价以及证据总结等。纳入文献的质量评价、证据提取和级别判定由2名研究者分别完成。结果共纳入文献15篇,涵盖5篇指南,1篇临床决策,3篇专家共识,2篇系统评价以及4篇证据总结。从术前评估、防护措施、俯卧位摆放、记录、教育培训5个方面汇总39条证据。结论做好术前风险评估,并且结合俯卧位手术特点对可改变的风险因素进行干预尤为重要。在临床实施过程中,严格按照体位摆放标准进行体位安置,并按实际情况制定适合各医疗机构的预防措施。
