Andreza Werli-Alvarenga

Corneal injuries: incidence and risk factors in the Intensive Care Unit

Patients hospitalized in the Intensive Care Unit (ICU) may present risk for corneal injury due to sedation or coma. This study aimed to estimate the incidence of corneal injuries; to identify the risk factors and to propose a risk prediction model for the development of corneal injury, in adult patients, in an intensive care unit of a public hospital. This is a one year, prospective cohort study with 254 patients. The data were analyzed using descriptive statistics, univariate and logistic regression. Of the 254 patients, 59.4% had corneal injuries and the mean time to onset was 8.9 days. The independent variables that predispose to risk for punctate type corneal injury were: duration of hospitalization, other ventilatory support device, presence of edema and blinking less than five times a minute. The Glasgow Coma Scale and exposure of the ocular globe were the variables related to corneal ulcer type corneal injury. The injury frequencies were punctate type (55.1%) and corneal ulcers (11.8%). Risk prediction models for the development of punctate and corneal ulcer type corneal injury were established.Pacientes internados en Unidad de Terapia Intensiva (UTI) pueden presentar riesgo de lesion en la cornea debido a la sedacion o al coma. Este estudio tuvo por objetivo estimar la incidencia de las lesiones en la cornea; identificar los factores de riesgo y proponer un modelo de prediccion de riesgo para el desarrollo de lesion en la cornea, en pacientes adultos, en Unidad de Terapia Intensiva, de un hospital publico. Estudio de cohorte prospectivo de un ano con 254 pacientes. Los datos fueron analizados por estadistica descriptiva, univariada y de regresion logistica. De los 254 pacientes, 59,4% tuvieron lesion en la cornea y el tiempo promedio para su aparicion fue de 8,9 dias. Las variables independientes que predisponen al riesgo de lesion en la cornea tipo punteada fueron: tiempo de internacion, otro dispositivo de asistencia ventilatoria, presencia de edema y parpadeo de ojos menor que cinco veces por minuto. La escala de coma de Glasgow y la exposicion del globo ocular fueron las variables relacionadas a la lesion en la cornea del tipo ulcera de cornea. Las lesiones fueron del tipo punteada (55,1%) y ulceras de cornea (11,8%). Modelos de prediccion de riesgo para lesiones en la cornea del tipo punteada y ulcera fueron establecidos.

Nursing Interventions for Adult Intensive Care Patients With Risk for Corneal Injury: A Systematic Review

PURPOSE:  Sedated patients in induced comas may experience ineffective eyelid closure, presenting higher risk for corneal ulcer. The objective was to identify evidence-based practice for corneal ulcer prevention within the intensive care unit. METHODS:  A systematic literature review of nine articles was performed. CONCLUSIONS:  Questions remain about which care practice is most effective, although most studies consider a humidity chamber with polyethylene film to be the best practice. IMPLICATIONS FOR NURSING PRACTICE:  A proposed NANDA-I nursing diagnosis, risk for corneal injury, reflects this human response that demands nursing assessment and intervention. This study provides evidence toward developing nursing interventions and practice guidelines for the care of these patients.PURPOSE Sedated patients in induced comas may experience ineffective eyelid closure, presenting higher risk for corneal ulcer. The objective was to identify evidence-based practice for corneal ulcer prevention within the intensive care unit. METHODS A systematic literature review of nine articles was performed. CONCLUSIONS Questions remain about which care practice is most effective, although most studies consider a humidity chamber with polyethylene film to be the best practice. IMPLICATIONS FOR NURSING PRACTICE A proposed NANDA-I nursing diagnosis, risk for corneal injury, reflects this human response that demands nursing assessment and intervention. This study provides evidence toward developing nursing interventions and practice guidelines for the care of these patients.

Lesões na córnea: incidência e fatores de risco em Unidade de Terapia Intensiva

Patients hospitalized in the Intensive Care Unit (ICU) may present risk for corneal injury due to sedation or coma. This study aimed to estimate the incidence of corneal injuries; to identify the risk factors and to propose a risk prediction model for the development of corneal injury, in adult patients, in an intensive care unit of a public hospital. This is a one year, prospective cohort study with 254 patients. The data were analyzed using descriptive statistics, univariate and logistic regression. Of the 254 patients, 59.4% had corneal injuries and the mean time to onset was 8.9 days. The independent variables that predispose to risk for punctate type corneal injury were: duration of hospitalization, other ventilatory support device, presence of edema and blinking less than five times a minute. The Glasgow Coma Scale and exposure of the ocular globe were the variables related to corneal ulcer type corneal injury. The injury frequencies were punctate type (55.1%) and corneal ulcers (11.8%). Risk prediction models for the development of punctate and corneal ulcer type corneal injury were established.Pacientes internados en Unidad de Terapia Intensiva (UTI) pueden presentar riesgo de lesion en la cornea debido a la sedacion o al coma. Este estudio tuvo por objetivo estimar la incidencia de las lesiones en la cornea; identificar los factores de riesgo y proponer un modelo de prediccion de riesgo para el desarrollo de lesion en la cornea, en pacientes adultos, en Unidad de Terapia Intensiva, de un hospital publico. Estudio de cohorte prospectivo de un ano con 254 pacientes. Los datos fueron analizados por estadistica descriptiva, univariada y de regresion logistica. De los 254 pacientes, 59,4% tuvieron lesion en la cornea y el tiempo promedio para su aparicion fue de 8,9 dias. Las variables independientes que predisponen al riesgo de lesion en la cornea tipo punteada fueron: tiempo de internacion, otro dispositivo de asistencia ventilatoria, presencia de edema y parpadeo de ojos menor que cinco veces por minuto. La escala de coma de Glasgow y la exposicion del globo ocular fueron las variables relacionadas a la lesion en la cornea del tipo ulcera de cornea. Las lesiones fueron del tipo punteada (55,1%) y ulceras de cornea (11,8%). Modelos de prediccion de riesgo para lesiones en la cornea del tipo punteada y ulcera fueron establecidos.

Predição de risco e incidência de olho seco em pacientes críticos

Objectives: to estimate the incidence of dry eye, to identify risk factors and to establish a risk prediction model for its development in adult patients admitted to the intensive care unit of a public hospital. Method: concurrent cohort, conducted between March and June, 2014, with 230 patients admitted to an intensive care unit. Data were analyzed by bivariate descriptive statistics, with multivariate survival analysis and Cox regression. Results: 53% out of 230 patients have developed dry eye, with onset mean time of 3.5 days. Independent variables that significantly and concurrently impacted the time for dry eye to occur were: O2 in room air, blinking more than five times per minute (lower risk factors) and presence of vascular disease (higher risk factor). Conclusion: dry eye is a common finding in patients admitted to adults intensive care units, and care for its prevention should be established.Objectives: to estimate the incidence of dry eye, to identify risk factors and to establish a risk prediction model for its development in adult patients admitted to the intensive care unit of a public hospital. Method: concurrent cohort, conducted between March and June, 2014, with 230 patients admitted to an intensive care unit. Data were analyzed by bivariate descriptive statistics, with multivariate survival analysis and Cox regression. Results: 53% out of 230 patients have developed dry eye, with onset mean time of 3.5 days. Independent variables that significantly and concurrently impacted the time for dry eye to occur were: O2 in room air, blinking more than five times per minute (lower risk factors) and presence of vascular disease (higher risk factor). Conclusion: dry eye is a common finding in patients admitted to adults intensive care units, and care for its prevention should be established.

Predicción de riesgo e incidencia de ojo seco en pacientes críticos

Objectives: to estimate the incidence of dry eye, to identify risk factors and to establish a risk prediction model for its development in adult patients admitted to the intensive care unit of a public hospital. Method: concurrent cohort, conducted between March and June, 2014, with 230 patients admitted to an intensive care unit. Data were analyzed by bivariate descriptive statistics, with multivariate survival analysis and Cox regression. Results: 53% out of 230 patients have developed dry eye, with onset mean time of 3.5 days. Independent variables that significantly and concurrently impacted the time for dry eye to occur were: O2 in room air, blinking more than five times per minute (lower risk factors) and presence of vascular disease (higher risk factor). Conclusion: dry eye is a common finding in patients admitted to adults intensive care units, and care for its prevention should be established.Objectives: to estimate the incidence of dry eye, to identify risk factors and to establish a risk prediction model for its development in adult patients admitted to the intensive care unit of a public hospital. Method: concurrent cohort, conducted between March and June, 2014, with 230 patients admitted to an intensive care unit. Data were analyzed by bivariate descriptive statistics, with multivariate survival analysis and Cox regression. Results: 53% out of 230 patients have developed dry eye, with onset mean time of 3.5 days. Independent variables that significantly and concurrently impacted the time for dry eye to occur were: O2 in room air, blinking more than five times per minute (lower risk factors) and presence of vascular disease (higher risk factor). Conclusion: dry eye is a common finding in patients admitted to adults intensive care units, and care for its prevention should be established.

Prediction of risk and incidence of dry eye in critical patients

Objectives: to estimate the incidence of dry eye, to identify risk factors and to establish a risk prediction model for its development in adult patients admitted to the intensive care unit of a public hospital. Method: concurrent cohort, conducted between March and June, 2014, with 230 patients admitted to an intensive care unit. Data were analyzed by bivariate descriptive statistics, with multivariate survival analysis and Cox regression. Results: 53% out of 230 patients have developed dry eye, with onset mean time of 3.5 days. Independent variables that significantly and concurrently impacted the time for dry eye to occur were: O2 in room air, blinking more than five times per minute (lower risk factors) and presence of vascular disease (higher risk factor). Conclusion: dry eye is a common finding in patients admitted to adults intensive care units, and care for its prevention should be established.Objectives: to estimate the incidence of dry eye, to identify risk factors and to establish a risk prediction model for its development in adult patients admitted to the intensive care unit of a public hospital. Method: concurrent cohort, conducted between March and June, 2014, with 230 patients admitted to an intensive care unit. Data were analyzed by bivariate descriptive statistics, with multivariate survival analysis and Cox regression. Results: 53% out of 230 patients have developed dry eye, with onset mean time of 3.5 days. Independent variables that significantly and concurrently impacted the time for dry eye to occur were: O2 in room air, blinking more than five times per minute (lower risk factors) and presence of vascular disease (higher risk factor). Conclusion: dry eye is a common finding in patients admitted to adults intensive care units, and care for its prevention should be established.

Lesiones en la córnea: incidencia y factores de riesgo en Unidad de Terapia Intensiva

Patients hospitalized in the Intensive Care Unit (ICU) may present risk for corneal injury due to sedation or coma. This study aimed to estimate the incidence of corneal injuries; to identify the risk factors and to propose a risk prediction model for the development of corneal injury, in adult patients, in an intensive care unit of a public hospital. This is a one year, prospective cohort study with 254 patients. The data were analyzed using descriptive statistics, univariate and logistic regression. Of the 254 patients, 59.4% had corneal injuries and the mean time to onset was 8.9 days. The independent variables that predispose to risk for punctate type corneal injury were: duration of hospitalization, other ventilatory support device, presence of edema and blinking less than five times a minute. The Glasgow Coma Scale and exposure of the ocular globe were the variables related to corneal ulcer type corneal injury. The injury frequencies were punctate type (55.1%) and corneal ulcers (11.8%). Risk prediction models for the development of punctate and corneal ulcer type corneal injury were established.Pacientes internados en Unidad de Terapia Intensiva (UTI) pueden presentar riesgo de lesion en la cornea debido a la sedacion o al coma. Este estudio tuvo por objetivo estimar la incidencia de las lesiones en la cornea; identificar los factores de riesgo y proponer un modelo de prediccion de riesgo para el desarrollo de lesion en la cornea, en pacientes adultos, en Unidad de Terapia Intensiva, de un hospital publico. Estudio de cohorte prospectivo de un ano con 254 pacientes. Los datos fueron analizados por estadistica descriptiva, univariada y de regresion logistica. De los 254 pacientes, 59,4% tuvieron lesion en la cornea y el tiempo promedio para su aparicion fue de 8,9 dias. Las variables independientes que predisponen al riesgo de lesion en la cornea tipo punteada fueron: tiempo de internacion, otro dispositivo de asistencia ventilatoria, presencia de edema y parpadeo de ojos menor que cinco veces por minuto. La escala de coma de Glasgow y la exposicion del globo ocular fueron las variables relacionadas a la lesion en la cornea del tipo ulcera de cornea. Las lesiones fueron del tipo punteada (55,1%) y ulceras de cornea (11,8%). Modelos de prediccion de riesgo para lesiones en la cornea del tipo punteada y ulcera fueron establecidos.