ABSTRACT
Objective To investigate the characteristics and risk factors of pressure injuries in patients admitted to the pediatric intensive care unit(PICU).Methods Totally 302 PICU patients were recruited from five tertiary general hospitals from December 2016 to April 2017.Data about the characteristics of the patients(demographic and clinical data),the assessment and characteristics of pressure injuries were collected and analyzed.Results The prevalence of pressure injuries in pediatric patients was 16.23％,in which 40.82％ were related to medical devices,and 81.63％ of the patients had grade 1 injury.The most commonly affected site was head and face(64.40％),followed by sacrococcygeal region(10.17％),heels(8.47％) and ankles(8.47％).The prevalence of pressure injuries was different among different diseases.Patients with pressure injuries were usually accompanied by serious condition,disturbance of consciousness,mechanical ventilation,surgical procedure,frequent use of medical devices and with low Braden Q scores.Conclusion Patients in PICU are high risk group,the key to prevent pressure injuries is early identification of risk factors and timely intervention.Clinical nurses should identify its characteristics timely and take corresponding protective measures.
ABSTRACT
Objective To evaluate the effects of early tracheotomy and delay tracheotomy on the prognosis of patients with severe craniocerebral injury.Methods Data of randomized controlled test (RCT) of early tracheotomy on the prognosis of the patients with severe craniocerebral injury were retrieved by using Conchrane Library,PubMed,Embase,OVID,CBM,CNKI,Wanfang and VIPdatahase.The retrievaled time was limited from their building to March 2016,and all the index of the obtained references was accessed.Two researchers independently screened the literature in accordance with the established criteria for inclusion or exclusion.The incidence of VAP,mechanical ventilation time and ICU length of hospital stay,mortality were considered as evaluation indexes.The methodology quality of the included references was evaluated,and the Meta-analysis was performed by using Review Manager 5.3 software.Results Finally,4 randomized controlled studies (RCT) were enrolled,including 220 patients.Meta-analysis results showed that:early tracheotomy did not have any effects on VAP incidence rate (P=0.15) and fatality rate (P=0.20) of the patients with severe craniocerebral injury,there was not any statistically difference;but there was a statistically difference between the mechanical ventilation (P =0.01) and ICU hospitalization time (P =0.05).Conclusion Early tracheostomy could not significantly reduce the incidence of VAP and fatality rate of the patients with severe craniocerebral injury,but it can reduce the mechanical ventilation time and ICU hospitalization time.