THE INFLUENCE OF VASOACTIVE DRUGS ON THE OCCURRENCE OF PRESSURE ULCERS IN THE SURGICAL INTENSIVE CARE UNIT
Keywords:
pressure ulcer, vasoactive drugs, Braden scale, intensive care unitAbstract
Background: A pressure ulcer (pressure injury) occurs when tissue loading and/or loading duration exceeds individual tissue tolerance. Risk factors for pressure ulcer development include mobility/activity limitations, skin condition, perfusion, circulation, oxygenation, moisture/microclimate, age, and diet. Patients in the intensive care unit (ICU) have additional risks for the development of pressure ulcers, such as the use of vasoactive drugs, prolonged treatment in the ICU, the presence of comorbidities (diabetes, cardiovascular diseases, hypotension), prolonged mechanical ventilation, hemodialysis and sedation, which confirms the complex nature of pressure ulcer development.
The aim: To examine the influence of vasoactive drugs on the incidence of pressure ulcers in the surgical intensive care unit.
Subjects and methods: The subjects were all patients with pressure ulcers treated in the surgical ICU, Clinic for Anesthesiology, Resuscitation, Intensive Care and Pain Therapy, University Hospital Center Zagreb over a 3-year period. All subjects were assessed for pressure ulcer risk using the Braden scale.
Results: The incidence of pressure ulcers was 5.7%, with no significant differences in gender or age. The most common risk factors included pressure, friction, traction, hypotension, and anemia. In most subjects, the pressure ulcer occurred in the ICU, formed in the sacrum, gluteal, and ischial regions, and was observed in stage II. Vasoactive drugs were used in all subjects. Noradrenaline was most commonly used.
Conclusion: Vasoactive drugs were used in all subjects, which indicates their association with decubitus. In future research, it is necessary to specify the dose, the time of application, to study each individual vasoactive drug, their synergistic effects, and to include all patients treated in the ICU, in order to examine the difference between patients with/without pressure ulcers with regard to the use of vasoactive drugs.
