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

The store-operated Ca2+ channel Orai1α is required for agonist-evoked NF-kB activation by a mechanism dependent on PKCβ2

La entrada de Ca2+ operada por almacenamiento es un mecanismo ubicuo de afluencia de Ca2+ en células de mamíferos que regula diversos procesos fisiológicos. La identificación de dos formas de Orai1, el canal operado por almacenamiento predominante, Orai1α y Orai1β, plantea la cuestión de si regulan de forma diferencial la función celular. Orai1α es el Orai1 completo, que contiene 301 aminoácidos, mientras que Orai1β carece de los 63 aminoácidos N-terminales. Aquí, utilizando una combinación de bioquímica e imagen combinada con el uso de células de riñón embrionario humano 293 KO, que carecen del Orai1 nativo, transfectadas con plásmidos que codifican para Orai1α u Orai1β, mostramos que Orai1α desempeña un papel relevante en la actividad transcripcional NF-κB inducida por agonistas. Por el contrario, Orai1β funcional no es necesaria para la activación de estos factores de transcripción. El papel de Orai1α en la activación de NF-κB es totalmente dependiente de la afluencia de Ca2+ e implica la activación de PKCβ. Nuestros resultados indican que Orai1α interactúa con PKCβ2 mediante un mecanismo que implica a la región de asociación AKAP79 exclusiva de Orai1α, lo que sugiere fuertemente un papel de AKAP79 en este proceso. Estos hallazgos proporcionan evidencias del papel de Orai1α en la actividad transcripcional NF-κB inducida por agonistas y revelan diferencias funcionales entre las variantes de Orai1.Store-operated Ca2+ entry is a ubiquitous mechanism for Ca2+ influx in mammalian cells that regulates a variety of physiological processes. The identification of two forms of Orai1, the predominant store-operated channel, Orai1α and Orai1β, raises the question whether they differentially regulate cell function. Orai1α is the full-length Orai1, containing 301 amino acids, whereas Orai1β lacks the N-terminal 63 amino acids. Here, using a combination of biochemistry and imaging combined with the use of human embryonic kidney 293 KO cells, missing the native Orai1, transfected with plasmids encoding for either Orai1α or Orai1β, we show that Orai1α plays a relevant role in agonist-induced NF-κB transcriptional activity. In contrast, functional Orai1β is not required for the activation of these transcription factors. The role of Orai1α in the activation of NF-κB is entirely dependent on Ca2+ influx and involves PKCβ activation. Our results indicate that Orai1α interacts with PKCβ2 by a mechanism involving the Orai1α exclusive AKAP79 association region, which strongly suggests a role for AKAP79 in this process. These findings provide evidence of the role of Orai1α in agonist-induced NF-κB transcriptional activity and reveal functional differences between Orai1 variants.• Agencia Española de Investigación. Proyecto PID2019-104084GB-C21/AEI/ 10.13039/501100011033 • Junta de Extremadura y Fondos FEDER. Becas IB20007 y GR21008, para José Antonio Rosado Dionisio • Junta de Extremadura y Fondo Europeo de Desarrollo Regional. Ayudas n. TA18011 y TA18054, para José Javier López Barba y Isaac Jardín Polo • Ministerio de Ciencia, Innovación y Universidades. Contrato para Joel Nieto Felipe y José Sánchez ColladopeerReviewe

Similarities and differences between the Orai1 variants: Orai1α and Orai1β

Orai1, el primer miembro identificado de la familia de proteínas Orai, se expresa de forma ubicua en el reino animal. Orai1 se caracterizó inicialmente como el canal responsable de la entrada de calcio de calcio (SOCE), un importante mecanismo que permite incrementos de la concentración de calcio citosólico citosólica de calcio tras la generación de IP3 mediada por receptores, lo que provoca el agotamiento de los almacenes intracelulares de Ca2+. Además, las pruebas actuales apoyan que la expresión o función anormal de Orai1 subyace a varios trastornos. Orai1 es, junto con STIM1, el elemento clave de SOCE, que conduce la liberación de Ca2+ (CRAC) y, en asociación con TRPC1, la corriente de Ca2+ operada por almacenamiento (SOC). Además, Orai1 participa en vías no capacitativas, como la corriente de Ca2+ regulada por araquidonato o por LTC4. o el canal de Ca2+ regulado por LTC4 (ARC/LRC), el influjo de Ca2+ independiente del almacén activado por la vía secretoria Ca2+-ATP1. (SPCA2) y el canal 3 de K+ activado por Ca2+ de pequeña conductancia (SK3). Además, Orai1 posee dos variantes, Orai1α y Orai1β, esta última carece de 63 aminoácidos en N-terminal en comparación con la forma Orai1 completa, lo que confiere características distintas a cada variante. Aquí revisamos los conocimientos actuales sobre las diferencias entre Orai1α y Orai1β, las implicaciones de las señales de Ca2+ desencadenadas por cada variante y su efecto modulador en la célula.Orai1, the first identified member of the Orai protein family, is ubiquitously expressed in the animal kingdom. Orai1 was initially characterized as the channel responsible for the storeoperated calcium entry (SOCE), a major mechanism that allows cytosolic calcium concentration increments upon receptor-mediated IP3 generation, which results in intracellular Ca2+ store depletion. Furthermore, current evidence supports that abnormal Orai1 expression or function underlies several disorders. Orai1 is, together with STIM1, the key element of SOCE, conducting the Ca2+ release-activated Ca2+ (CRAC) current and, in association with TRPC1, the store-operated Ca2+ (SOC) current. Additionally, Orai1 is involved in non-capacitative pathways, as the arachidonate-regulated or LTC4-regulated Ca2+ channel (ARC/LRC), store-independent Ca2+ influx activated by the secretory pathway Ca2+-ATPase (SPCA2) and the small conductance Ca2+-activated K+ channel 3 (SK3). Furthermore, Orai1 possesses two variants, Orai1α and Orai1β, the latter lacking 63 amino acids in the N-terminus as compared to the full-length Orai1 form, which confers distinct features to each variant. Here, we review the current knowledge about the differences between Orai1α and Orai1 β, the implications of the Ca2+ signals triggered by each variant, and their downstream modulatory effect within the cell.• Agencia Estatal de Investigación. Proyecto PID2019-104084GB-C21/AEI/10.13039/501100011033 • Junta de Extremadura y Fondos FEDER. Subvenciones IB20007 y GR21008, para José Antonio Rosado Dionisio • Junta de Extremadura. Contrato de Alejandro Berna Erro • Junta de Extremadura. Proyecto TA18011 y contrato Juan José López Barba • Agencia Estatal de Investigación. Contratos de José Sánchez Collado y Joel Nieto FelipepeerReviewe

Correspondencia enviada a Pedro Agustín de Valencia

Correspondencia enviada a Pedro Agustín de Valencia por: Francisco Damián de Espejo, Francisco Antonio de Arboleda, la marquesa de Val de Hoyos [María Francisca de Miranda Gómez], Manuel de Valencia, Felipe Nieto Polo, Pedro Villamil, Gaspar de Valencia y María Núñez, sobre asuntos y negocios personales. Fechada en Quito, Cuenca, Málaga, Cartagena, Santafé y Popayán

Divulgación Científica No.3

La investigación constituye en sí misma un valioso instrumento para ser empleado por la sociedad, es mucho más que un objeto —sin abandonar lo que por naturaleza le compete: garantizar procesos de calidad—, puede entregar valiosa información sobre diferentes temas de interés, para avanzar en el análisis y propiciar la creación de redes de conocimiento.Research constitutes in itself a valuable instrument to be used by society, it is much more than an object —without abandoning what by nature is its responsibility: guaranteeing quality processes—, it can provide valuable information on different topics of interest, to advance in analysis and promote the creation of knowledge networks

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

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