Incidencia de lesiones por presión en unidades de cuidados intensivos pediátricas y neonatalesrevisión sistemática (2000-2016)

  1. Joan-Enric Torra-Bou 1
  2. Gemma Pérez-Acevedo 2
  3. Alejandro Bosch-Alcaraz 2
  4. Francisco P. García-Fernández 1
  5. Raquel Sarabia-Lavin 3
  6. J Javier Soldevilla-Agreda 1
  7. José Verdú-Soriano 1
  1. 1 Universitat de Lleida
    info

    Universitat de Lleida

    Lleida, España

    ROR https://ror.org/050c3cw24

  2. 2 Hospital Sant Joan de Deu
    info

    Hospital Sant Joan de Deu

    Barcelona, España

    ROR https://ror.org/001jx2139

  3. 3 Universidad de Cantabria
    info

    Universidad de Cantabria

    Santander, España

    ROR https://ror.org/046ffzj20

Revista:
Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

ISSN: 1134-928X

Año de publicación: 2020

Volumen: 31

Número: 3

Páginas: 180-192

Tipo: Artículo

DOI: 10.4321/S1134-928X2020000300010 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

Objetivos de desarrollo sostenible

Resumen

ABSTRACT Aims: To describe the incidence and main characteristics of pressure injuries in pediatric patients in intensive care units and some variables related to the methodology for pressure injury incidence calculation. Background: Pressure injuries (PI) represent a serious health problem with major consequences for the patients affected. Neonatal and pediatric ICU (NICU) (PICU) care for patients at high risk of developing pressure injuries. There is a paucity of systematic data on the incidence and defining variables of injuries in PICU and NICU. Methods: We conducted a systematic review of the literature published between January 1, 2000 and December 31, 2016, including articles reporting data on the incidence of these injuries in PICU or NICU. We included studies reporting data on pressure injuries related to position, with or without injuries related to medical devices; we excluded studies which only reported data on pressure injuries related to medical devices. Findings: We identified 27 articles with a total of 53 reports on incidence and information on 15,587 patients. In the case of PICU, the mean incidence of PI was 19.4% in prospective studies that did not implicitly include PI related to medical devices, and 16.97% in those which included pressure injuries related both to medical devices and position. For NICU, we found values of 3.9% and 23.58% respectively. Conclusions: The results of this study shed light on the incidence of pressure injuries in pediatric intensive care patients and highlight aspects related to the methodology used for the calculation of PI incidence.

Referencias bibliográficas

  • Torra-Bou, JE,Verdú-Soriano, J,Sarabia-Lavin, R,Paras-Bravo, P,Soldevilla-Agreda, JJ,García-Fernández, FP. (2016). Las úlceras por presión como problema de seguridad del paciente. Gerokomos. 27. 161
  • Kottner, J,Balzer, K,Dassen, T,Heinze, S. (2009). Pressure ulcers: A critical review of definitions and classifications. Ostomy Wound Manage. 55. 22
  • García-Fernández, FP,Soldevilla Agreda, JJ,Verdú, J,Pancorbo-Hidalgo, PL. (2014). A new theorical model for the developement of pressure ulcers and other dependence-related lesions. J Nurs Schol. 46. 28-38
  • García-Fernández, FP,Soldevilla Agreda, JJ,Pancorbo Hidalgo, PL. (2014). Clasificación-categorización de las lesiones relacionadas con la dependencia. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • Haesler, E. (2014). National Pressure Ulcer Advisory Panel Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Cambridge Media. Osborne Park, Western Australia.
  • National Pressure Ulcer Adivisory Panel. NPUAP Pressure Injury stages.
  • García-Fernández, FP,Pancorbo-Hidalgo, PL,Soldevilla Agreda, JJ. (2011). Escalas de valoración del riesgo de desarrollar úlceras por presión en la infancia. Gerokomos. 22. 26-34
  • García-Fernández, FP,Pancorbo-Hidalgo, P,Soldevilla Agreda, JJ,Rodríguez Torres, MC. (2013). Valoración del riesgo de desarrollar úlceras por presión en unidades de cuidados críticos: revisión sistemática con metanálisis. Gerokomos. 24. 82
  • Braden, B,Bergstron, N. (1987). A Conceptual schema for the study of the etiology of pressure sores. Rehab Nurs. 12. 8-16
  • Coleman, S,Gorecki, C,Nelson, AE,Closs, SJ,Defloor, T,Halfens, R. (2013). Patient risk factors for pressure ulcer development: Systematic review. Int J Nurs Stud. 50. 974-1003
  • Torra i Bou, JE,Rodríguez Palma, M,Soldevilla Ágreda, JJ,García Fernández, FP,Sarabia Lavín, R,Zabala Blanco, J. (2013). Redefinición del concepto del abordaje de las lesiones por humedad. Una propuesta conceptual y metodológica para mejorar el cuidado de las lesiones cutáneas asociadas a la humedad (LESCAH). Gerokomos. 24. 90
  • Torra i Bou, JE. (2016). Incidencia de úlceras por presión en unidades de cuidados intensivos. Revisión sistemática con meta-análisis. Universidad de Alicante.
  • Murray, JS,Noonan, C,Quigley, S,Curley, MAQ. (2013). Medical device-related hospital acquired pressure ulcers in children: An integrative review. J Pediatr Nurs. 28. 585
  • Razmus, I,Lewis, L,Wilson, D. (2008). Pressure ulcer development in infants: State of the Science. J Healthcare Qual. 30. 36-42
  • Baldwin, KM. (2002). Incidence and prevalence of pressure ulcers in children. Adv Skin Wound Care. 15. 121
  • August, DL,Edmonds, L,Brown, DK,Murphy, M,Kandasamy, Y. (2014). Pressure injuries to the skin in neonatal unit: Fact or fiction. J Neonatal Nurs. 20. 129
  • Fujii, K,Sugama, J,Okuwa, M,Sanada, H,Mizokami, Y. (2010). Incidence and risk factors of pressure ulcers in seven neonatal intensive care units in Japan: a multisite prospective cohort study. Int Wound J. 7. 323
  • Huffines, B,Logsdon, MC. (1997). Thre neonatal skin assessment scale for predicting skin breakdown in neonates. Issues Comprehes Pediatr Nurs. 20. 26-31
  • McCord, S,McElvain, V,Sachdeva, R,Schwartz, P,Jefferson, LS. (2004). Risk factors associated with pressure ulcers in the intensive care unit. J WOCN. 31. 179
  • Baharestani, MM,Ratliff, CR. (2007). Pressure Ulcers in Neonates and Children: An NPUAP White Paper. Adv Skin Wound Care. 20. 208-218
  • Quigley, SM,Curley, MAQ. (1996). Skin integrity in the pediatric population: Preventing and managing pressure ulcers. JSPN. 1. 7-18
  • Sims, A,McDonald, R. (2003). An overview of paediatric pressure care. J Tiss Viab. 13. 144
  • McLane, KM,Bookout, K,McCord, S,McCain, J,Jefferson, LS. (2004). The 2003 national pediatric pressure ulcer and skin breakdown prevalence survey. J WOCN. 31. 168
  • Willock, J,Baharestani, MM,Anthony, D. (2009). The development of the Glamorgan paediatric pressure ulcer risk assessment scale. J Wound Care. 18. 17-21
  • Pancorbo-Hidalgo, PL,García-Fernández, FP,Torra i Bou, JE,Verdú Soriano, J,Soldevilla-Agreda, JJ. (2014). Epidemiología de las úlceras por presión en España en 2013: 4ª Estudio Nacional de Prevalencia. Gerokomos. 25. 162
  • Pancorbo-Hidalgo, PL,Torra-Bou, JE,García-Fernández, FP,Soldevilla-Agreda, JJ. (2018). Prevalence of pressure injuries and other dependence-related skin lesions among paediatric patients in hospitals in Spain. EWMA J. 19. 29-37
  • VanGilder, C,Amiung, S,Harrison, P,Meyer, S. (2009). Results of the 1008-2009 International Pressure Ulcer Prevalence Survey and a 3-year, acute care, unit-specific analysis. Ostomy Wound Manage. 55. 39-45
  • Still, MD,Cross, LC,Dunlap, M,Rencher, R,Larkins, ER,Carpenter, DL. (2013). The turn team: A novel strategy for reducing pressure ulcers in the surgical intensive care unit. J Am Coll Surg. 216. 373
  • Willock, J,Harris, C,Harrison, J,Poole, CH. (2005). Identifying the characteristics of children with pressure ulcers. Nurs Times. 101. 40
  • Lu, Y-F,Yang, Y,Wang, Y. (2015). Predicting pressure ulcer risk with the Braden Q Scale in Chinese pediatric patients in ICU. Chin Nurs Res. 2. 1-5
  • Ye-Feng, LE,Jian-hua, L,Xiu-wen, LJ. (2009). Evaluation on applying pediatric pressure ulcer assessment scale. Nurs J Chin People's Liberation Army. 26. 1-4
  • Cockett, A. (2002). A research review to identify the factors contributing to the development of pressure ulcers in paediatric patients. J Tissue Viability. 12. 16-23
  • Kottner, J,Wilborn, D,Dassen, T. (2010). Frequency of pressure ulcers in the paediatric population: A literature review and new empirical data. Int J Nurs Stud. 47. 1330
  • National Library of Medicine. Medical Subjects Headings (MESH).
  • Moher, D,Liberati, A,Tetzlaff, J. (2019). The PRISMA Group Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 6.
  • Urrutia, G,Bonfill, X. (2010). Declaración PRISMA una propuesta para mejorar la publicación de revisiones sistemáticas y análisis. Med Clin (Barc). 135. 507
  • CASPE. Disponible en: http://www.redcaspe.org/ [acceso 1 de noviembre de 2019].
  • Cabello, JB. (2005). CASPe CASPe. Guías CASPe de Lectura Crítica de la Literatura Médica. CASPe. Alicante.
  • Shea, BJ,Grimshaw, JM,Wellsa, GA. (2007). Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 7.
  • Curley, MAQ,Thompson, JE,Arnold, JH. (2000). The effects of early repeated prone positioning in pediatric patients with acute lung injury. Chest. 118. 156
  • Willock, J,Hughes, J,Tickle, S. (2000). Pressure sores in children - the acute hospital perspective. J Tissue Viability. 10. 59-62
  • Jones, I,Tweed, C,Marron, M. (2001). Pressure area care in infants and children: Nimbus® Paediatric system. Br J Nurs. 10. 789
  • Murdoch, V. (2002). Pressure care in the pediatric intensive care unit. Nurs Stand. 17. 71
  • Curley, MAQ,Quigley, SM,Lin, M. (2003). Pressure ulcers in pediatric intensive care: incidence and associated factors. Pediatr Crit Care Med. 4. 284
  • Curley, MAQ,Hibberd, PI,Fineman, LD,Wypij, D,Shih, M-Ch,Thompson, JE. (2005). Effect of prone positionng on clinical outcomes in children with acute lung injury. JAMA. 294. 229
  • Fineman, LD,LaBrecque, MA,Shih, M-CH,Curley, AQ. (2006). Prone position can be safely performed in critically ill infants and children. Pediatr Crit Care Med. 7. 413
  • Cruces, P,Donoso, A,Díaz, F,López, A,Valenzuela, J. (2007). Tiempo-dependencia de la respuesta a posición prono prolongado en síndrome de Distress respiratorio agudo grave. Rev Chil Med Intens. 22. 235
  • Schindler, CA,Mikhailov, TA,Fischer, K,Lukasiewiicz, G,Kuhn, EM,Duncan, L. (2007). Skin integrity in critically ill and injured children. Am J Crit Care. 16. 568
  • Díaz Alonso, Y,Riveiro Vela, AM,González Pérez, M. (2009). Prevención de úlceras por presión. Resultados de un programa de prevención en unidad de cuidados intensivos pediátricos. Rev Rol Enf. 32. 361
  • Gordon, MD,Gottschlich, MM,Helvig, EI,Marvin, Ja,Richard, RL. (2004). Review of Evidenced-Based Practice for the Prevention of Pressure Sores in Burn Patients. J Burn Care Rehab. 26. 388-410
  • Aparicio Santiago, GL,Ponce Gómez, G,Carmona Mejia, B. (2010). Cuidados de la piel del niño y factores de riesgo para desarrollar úlceras por presión. Rev Enferm Univ ENEO-UNAM. 7. 7-15
  • Mencía, S,Berroya, A,López Herce, J,Botrán, M,Urbano, J,Carrillo, Á. (2010). Efectos de la hipotermia inducida en niños críticos. Med Intensiva. 34. 363
  • Bezerra Carvalho, G,Araujo da Silva, FA,Castro, ME de,Sampaio Florêncio, R. (2011). Epidemiologia e riscos asociados á úlceras por pressao em crianças. Cogitare Enferm. 16. 640
  • Schindler, CHA,Mikhailov, TA,Khun, EM,Christopher, J,Conway, P,Ridling, D. (2011). Protecting fragile skin: Nursing interventions to decrease development of pressure ulcers in pediatric intensive care. Am J Crit Care. 20. 26-34
  • Ticozzelli, E,Tessore, N,Bordone, T,Bona, G. (2011). Prevenzione delle lesion de presione nel bambino sottoposto ad intervento cardiochirurgico Idb. Giornale Italiano di Scienze Inferieristiche Pediatriche. 3. 61
  • Chiari, P,Poli, M,Magli, C,Bascelli, E,Rocchi, R,Bolognini, S. (2012). Studio di coorte prospettico multicentrico per la validazione italiana della Braden Q per la valutazione del rischio di lesioni da decubito nei neonati e nei bambini fino ad 8 anni. Assist Inferm Ric. 31. 83-90
  • García Molina, P,Balaguer López, E,Torra i Bou, JE,Alvarez-Ordiales, A,Quesada-Ramos, C,Verdú Soriano, J. (2012). A prospective, longitudinal study to assess use of continuous and reactive low-pressure mattress to reduce pressure ulcer incidence in a pediatric intensive care unit. Ostomy Wound Manage. 58. 32
  • Schindler, CHA,Mikhailov, TA,Cashin, SE,Malin, S,Christensen, M,Winters, JM. (2013). Under pressure: preventing pressure ulcers in critically ill infants. J Spec Pediatr Nurs. 18. 329
  • Tume, LN,Siner, S,Scott, E,Lane, S. (2013). The prognostic ability of early Braden Q Scores in critically ill children. Nurs Crit Care. 19. 98-103
  • Visscher, M,King, A,Nie, AM,Schaffer, P,Taylos, R,Pruitt, D. (2013). A quality-improvement collaborative project to reduce pressure ulcers in PICUs. Pediatrics. 131. 1950
  • Sarduy Lugo, S,Collado Cabañín, LE,Sarduy Lugo, A. (2015). Efectividad de un protocolo de cuidados para prevenir úlceras por presión en un hospital pediátrico. Rev Cult Cuid. 12. 7-15
  • Won-Young, Ch,Hyeon-Ok, J. (2012). Incidence and associated factors of pressure ulcers in newborns. J Korean Acad Child Health Nurs. 18. 177
  • Visscher, M,Taylor, T. (2014). Pressure Ulcers in the Hospitalized Neonate: Rates and Risk Factors. Scient Rep. 4.
  • Willock, J,Habiballah, L,Long, D,Palmer, K,Anthony, D. (2016). A comparison of the performance of the Braden Q and the Glamorgan paediatric pressure ulcer risk assessment scales in general and intensive care paediatric and neonatal units. J Tiss Viab. 25. 119
  • Reilly, EF,Karaskousis, GC,Schrag, SP,Stawicki, SP. (2007). Pressure ulcers in the intensive care unit: The "forgotten" enemy. OPUS 12 Scientist. 1. 17-30
  • Theaker, C,Mannan, M,Ives, N,Soni, N. (2000). Risk factors for pressure sores in the critically ill. Anesthesia. 55. 221
  • Bates, DW,Leape, L,Petrvcki, S. (1993). Incidence and preventability of adverse drug events in hospitalized patients. J Gen Intern Med. 8. 289
  • Stanphone, N,Crowley-Murphy, M,Vincent, C,O'Connor, AM,Taylor-Adams, SE. (1999). An evaluation of adverse incident reporting. J Eval Clin Prac. 5. 5-12
  • Watcher, RM,Pronovost, PJ,Shekelle, PG. (2013). Strategies to improve patient safety: The evidence base matures. Ann Intern Med. 158. 350
  • Westbrook, JI,Li, L,Lehnbon, EC. (2015). What are incident reports telling us? A comparative study at two Australian hospitals of medication errors identified at audit, detected by staff and reported to an incident system. Int J Qual Health Care. 27. 1-9
  • Hopf, YM,Francis, J,Helms, PJ,Haughney, J,Bond, C. (2016). Linking NHS data for pediatric pharmacovigilance: Results of a Delphi survey. Res Soc Admin Pharm. 12. 267
  • Sujan, M. (2015). An organization without a memory: A qualitative study of hospital staff perceptions on reporting and organizational learning for patient safety. Reiability Engin Syst Saf. 144. 45-52
  • Torra i Bou, JE. (1998). Epidemiología de las úlceras por presión. O el peligro de una nueva Torre de Babel. Rev Rol Enf. 238. 75-88