Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Stability analysis of grouting surrounding rock in fracture zone in coal seam floor

Affected by the geological concealment and complexity, there is a potential safety risk of mining induced damage due to insufficient grouting in fissures. Based on the analysis method of combining numerical simulation and microseismic monitoring, the grouting treatment effect of water conducting channel is analyzed based on the background of the grouting floor of 1612A working face in Zhangji Coal Mine. The influence of mining stress and the stability of grouting rock mass are revealed before and after grouting. The results show that: compared with the non-grouting, the abnormal stress area of surrounding rock decreases. The coupling is no longer connected to the working face. After 10 m away from the roadway side, the disturbance degree decreases with the increase of distance. Microseismic monitoring further verified the calculation results: the rock fracture signal “detours” in the grouting affected area. The number of microseismic events in surrounding rock area is small, and the grouted rock mass is in stable state

Preliminary Study on High-Energy and Low-Energy Microfracture Event Evolution Characteristics in the Development Process of Rock Failure

The evolution characteristics of high-energy and low-energy microfracture events play an important role in the brittle failure mechanism of rock and reasonable microseismic (MS) monitoring and acoustic emission (AE) monitoring. The bimodal distribution (BMD) model is commonly used to observe the evolution characteristics of high-energy and low-energy MS events; however, its precise mechanism remains unclear. The evolution characteristics of high-energy and low-energy microfracture events are assessed in this study based on a BMD model. MS monitoring results from the No. 22517 working face of the Dongjiahe Coal Mine are studied, and AE monitoring results of a biaxial compression experiment of a granite specimen are analyzed. High-energy MS events in the No. 22517 working face are found to be generated by an increase in the failure scale of the overlying rock mass upon exiting the insufficient mining stage and entering the sufficient mining stage. The change characteristics of the high-energy AE hits are positively correlated with crack evolution characteristics in the granite specimen and negatively correlated with changes in the Gutenberg-Richter b value. A precise high-energy and low-energy AE hit evolution mechanism is analyzed based on the microscopic structure of the granite specimen. Similarities and differences between high-energy MS events and low-energy AE hits are determined based on these results. Both are found to have bimodal characteristics; an increase in the failure scale is identified as the root cause of the high-energy component. The bimodal distribution of AE hits is far less obvious than that of MS events

A New Quantitative Method for Risk Assessment of Coal Floor Water Inrush Based on PSR Theory and Extension Cloud Model

In order to scientifically and reasonably assess the risk of water inrush from the coal seam floor, considering the influence of natural environmental factors such as hydrogeology, mining, and human intervention, the PSR model of ecosystem health evaluation was introduced, and the risk evaluation indicator system of water inrush from the coal seam floor was established. In order to solve the randomness and fuzziness of water inrush event evaluation, the evaluation model is constructed based on extension cloud theory and is applied in the 12123 working face of Pan Er coal mine of Huainan Mining Group. The application results show that the evaluation results are basically consistent with the actual situation, which shows that the model can be used in the actual evaluation work and is scientific

Grouting Mechanism in Water-Bearing Fractured Rock Based on Two-Phase Flow

Grouting is always used in mine water plugging, reinforcement, and other disaster prevention projects. The diffusion mechanism of slurry in fractured rock is affected by geological environment and slurry performance, which should be revealed and characterized better. Based on the two-phase flow diffusion theory, a slurry diffusion model considering flowing water condition was established for a blocking area of a fracture zone in one case from China. The feasibility of two-phase flow model in grouting diffusion calculation was analyzed. The diffusion model in dynamic water environment was studied, and the diffusion range varying with time in the grouting area of Zhangji Coal Mine was explored. The optimization method of multi grouting holes was put forward, and the influence of water flowing was discussed. The results show that the slurry diffusion calculated by the two-phase flow model was feasible and consistent with the experimental study. The dynamic water can change the conventional circular diffusion state of slurry, but its pattern was oval and leaf type. There were different penetration distances in directions, and typical grouting voids were made on the side and upstream. When the single-hole grouting was carried out, the predetermined value can be achieved in the height range, but it was only about 15 m on the side because of the water flowing, which cannot meet the requirements. The optimization scheme of grouting was put forward, which adopted multiple grouting holes in the long side, and grouting in different directions and periods to avoid the possible problems of multihole intersection. The rationality and effectiveness of the proposed optimization method were verified through the calculation of water yield and analysis of cement composition from the drilling core in the grouted zone. In the grouting process, the water flowing has double effects, which has a significant role in promoting and scouring along the flow direction, but there is a significant weakness in the side diffusion. It is very important to realize the rational use of the dynamic water through the optimization scheme. This study is an important basic work of grouting mechanism, and it is expected to promote the development of grouting technology and application of two-phase fluid-solid coupling theory

Identification method of hidden structure reactivation based on microseismic and numerical simulation

The microseismic monitoring can be used to identify and predict the activations strength of rock breaking, faults or hidden structures, and the use of numerical simulation technology can realize the inversion and reproduction of the stress field in the structural activation zone, the two complement each other, which can realize stress disturbance- stress concentration- local micro fracture- stress migration captured from internal cause to the appearance in the whole activation process of hidden structure. Based on the production and geological conditions of 1612A working face in Zhangji Coal Mine of Huaihe Energy Group, and the microseismic(MS) monitoring system, the temporal and spatial distribution characteristics of MS events were analyzed in the stope. The relationship between microseismic activity and fault activation was explored. And the identification method of hidden structure activation was proposed with the inversion of numerical simulation based on the MS data. The results show that, the MS events in the stope had typical time-phased and spatial regional distribution characteristics. Combined with the source parameters, it is determined that there is an abnormal area near the faults of F1611A76-F1611A7677, which was suspected to be a derivative fault of these faults. Through numerical simulation of the stress changes under two conditions to respond to the energy release law, the inversion results indicated that there were hidden structures in the measured area. Through field survey and trough wave geophysical exploration, it was found that there were typical broken abnormal areas in the specific range, which further verified the feasibility and accuracy of MS monitoring combined with numerical simulation to identify the activation of hidden structures

High performance lithium-ion capacitors based on dynamic matching principle

As a new generation of energy storage devices, lithium-ion capacitors (LICs) rationally combine high energy density and high power density, providing an alternative solution for multi-functional electronic equipment and state grid system. However, the dynamic mismatch between the battery-type anode and the capacitor-type cathode seriously limits its development and application. Herein, a high performance LIC simultaneously using carbon materials derived from Ethylenediaminetetraacetic Acid Ferric Sodium Salt (EDTA-Na-Fe) was prepared. By calcination of EDTA-Na-Fe in an inert atmosphere, nitrogen-doped carbon frameworks (NCF) can be obtained which possess a high reversible capacity and excellent rate-capability. Using this NCF as the anode and cathode of the LICs, the hybrid devices with a wide voltage window of 0.5-4.0 V are obtained. The employment of the same materials as the anode and cathode can largely simplify the fabrication process. The energy density of LICs can reach 193.4 Wh·kg-1 at a power density of 225 W·kg-1. This reasonable dynamic matching strategy can be helpful for the application of LICs