Electrochemical immunosensor modified with carbon nanofibers coupled to a paper platform for the determination of gliadins in food samples

The gluten-free diet is a unique, effective treatment for different conditions related to gluten consumption. Therefore, it is crucial the availability of new methodologies for the sensitive and specific determination of gluten content in food samples. Herein, a screen printed electrode modified with carbon nanofibers coupled to a paper immunoaffinity platform was reported for the determination of gliadin in foods samples. The paper microzone covalently functionalized with specific anti-gliadin antibodies was placed on the modified electrode surface for the electrochemical determination of gliadin. The surface of the electrode modified with carbon nanofibers was characterized by scanning electron microscopy (SEM) and cyclic voltammetry (CV), which showed the improved sensitivity of the modified surface. The developed device was evaluated using different flour samples obtaining a favorable response. The calculated limit of detection for the device in analyzed samples was 0.005 mg kg -1 and for the enzyme-linked immunosorbent assay was 1.5 mg kg -1 . The coefficient of variation (CV) for the determination of 20 μg kg -1 of gliadin was 4.11%. The disposable electrochemical sensor developed, represents an easy-to-use and low-cost strategy for the determination of gliadin in food samples.Fil: Marin Barroso, Evelyn del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Messina, Germán Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Bertolino, Franco Adrián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Raba, Julio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Pereira, Sirley Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; Argentin

Laser-induced fluorescence integrated in a microfluidic immunosensor for quantification of human serum IgG antibodies to Helicobacter pylori

A portable immunosensor coupled to laser-induced fluorescence (LIF) detection system has been successfully developed. It was applied to the quantitative determination of specific IgG antibodies against Helicobacter pylori present in human serum samples. This system is a relevant alternative tool for the diagnostic of peptic ulcer and gastritis diseases produced by H. pylori, which are recognized risk factors for the development of gastric mucosa associated lymphoid tissue lymphoma and gastric adenocarcinoma. More than 50% of the population has been affected by H. pylori, one of the most widespread infections around the world. Our proposed system combines the LIF detection, which offers great sensibility with the specificity of the immunological reactions and the microfluidic technology. The device has a central channel (CC) with packed H. pylori antigen immobilized on 3-aminopropyl-modified controlled pore glass (AP-CPG). Antibodies in serum samples reacted immunologically with the immobilized antigen and then, they were determined using alkaline phosphatase (AP) enzyme-labeled second antibodies specific to human IgG. The 4-methylumbelliferyl phosphate (4-MUP), employed as enzymatic substrate, was converted to soluble fluorescent methylumbelliferone by AP, and this fluorescent product was finally quantified by LIF detection system. The calculated detection limits for LIF detection and the ELISA procedure were 0.17 and 2.1 U mL -1, respectively, and the within- and between-assay coefficients of variation were below 5.1%.Fil: Seia, Marco Abel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Pereira, Sirley Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Carlos A. Fontán. Universidad Nacional de San Luis; ArgentinaFil: de Vito, Irma Esther. Universidad Nacional de San Luis; ArgentinaFil: Messina, Germán Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Raba, Julio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentin

Zinc oxide nanoparticles based microfluidic immunosensor applied in congenital hypothyroidism screening

In this article, we present an innovative approach for congenital hypothyroidism (CHT) screening. This pathology is the most common preventable cause of mental retardation, affecting newborns around the world. Its consequences could be avoided with an early diagnosis through the thyrotropin (TSH) level measurement. To accomplish the determination of TSH, synthesized zinc oxide (ZnO) nanobeads (NBs) covered by chitosan (CH), ZnO-CH NBs, were covalently attached to the central channel of the designed microfluidic device. These beads were employed as platform for anti-TSH monoclonal antibody immobilization to specifically recognize and capture TSH in neonatal samples without any special pretreatment. Afterwards, the amount of this trapped hormone was quantified by horseradish peroxidase (HRP)-conjugated anti-TSH antibody. HRP reacted with its enzymatic substrate in a redox process, which resulted in the appearance of a current whose magnitude was directly proportional to the level of TSH in the neonatal sample. The structure and morphology of synthesized ZnO-CH NBs were characterized by scanning electron microscopy (SEM) and X-ray diffraction (XRD). The calculated detection limits for electrochemical detection and the enzyme-linked immunosorbent assay procedure were 0.00087 μUI mL-1 and 0.015 μUI mL-1, respectively, and the within- and between-assay coefficients of variation were below 6.31 % for the proposed method. According to the cut-off value for TSH neonatal screening, a reasonably good limit of detection was achieved. These above-mentioned features make the system advantageous for routine clinical analysis adaptation.Fil: Seia, Marco Abel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Pereira, Sirley Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Fernández Baldo, Martín Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: de Vito, Irma Esther. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Raba, Julio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Messina, Germán Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; Argentin

Novel electrochemical sensing platform based on a nanocomposite of PVA / PVP / RGO applied to IgG anti- Toxoplasma gondii antibodies quantitation

This article describes the development of a new electrochemical platform composed by a polymer mixture and graphene oxide (GO). The working electrode of a screen-printed carbon electrode (SPCE) was modified with nanocomposite constituted by poly-vinyl alcohol (PVA), poly-vinylpyrrolidone (PVP) and GO, which was electrochemically reduced to obtain PVA/PVP/RGO/SPCE. The interactions and morphology of the PVA/PVP/GO nanocomposite were investigated by SEM, FTIR and UV-Vis. SEM images indicated an excellent dispersion of the GO sheets in the polymer matrix. Besides, FTIR and visible UV studies revealed strong interactions between polymer mixture and GO sheets. According to electrochemical studies, the new platform increased the electroactive surface area by a factor of 20.46 compared to the unmodified SPCE. Also, the PVA/PVP/RGO/SPCE had a fast electron kinetics transfer process with a value of ks = 9.6 s-1.The modified electrode was applied to the determination of IgG anti-T. gondii antibodies for the serological diagnosis of toxoplasmosis. The IgG anti-T. gondii antibodies quantification showed a detection limit of 0.012 U mL-1, and the coefficients of variation intra-day and inter-day assays were lower than 4.5% and 6.2%, respectively. The electrochemical platform proved to be a sensitive and easily applicable tool applied to the serological diagnosis of toxoplasmosis. Therefore, the developed nanocomposite represents an excellent alternative for the electrochemical biosensor fabrication.Fil: Takara, Eduardo Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Pereira, Sirley Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Scala Benuzzi, María Luz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Fernández Baldo, Martín Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Raba, Julio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Messina, Germán Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentin

Paper surface modification strategies employing N-SBA-15/polymer composites in bioanalytical sensor design

In this work, different paper surface modification strategies were compared to obtain an amine functionalized SBA-15 (N-SBA-15) composite for paper-based device development. The synthesized N-SBA-15 was characterized by N 2 adsorption-desorption isotherm, and infrared spectroscopy (FTIR), and it was incorporated to different polymer matrices (κ-carrageenan (CA), polyvinyl alcohol (PVA) and polyethylenimine (PEI)) for the development of the composite modified paper-based device. The retention, interactions, and morphology of the obtained composites were investigated by absorbance measurement, FTIR and scanning electron microscopy (SEM), respectively. To demonstrate the applicability of the modified paper-based device, ascorbic acid (AA) quantification was carried out. Horseradish peroxidase (HRP) was immobilized onto the modified paper surface. HRP in the presence of H 2 O 2 catalyzes the oxidation of 10-acetyl-3,7-dyhidroxyphenoxazine (ADHP) to highly fluorescent resorufin, which was measured by LIF detector. Thus, when AA was added to the solution, it decreases the relative fluorescence signal proportionally to the AA concentration. The linear range from 50 nmol L −1 to 1500 nmol L −1 and a detection limit of 15 nmol L −1 were obtained for AA quantitation. The obtained results allowed us to conclude that N-SBA-15/PEI composite could be considered an excellent choice for the paper-based device modification procedure due to its inherent simplicity, low cost, and sensitivity.Fil: Moreira, Cristian Matias. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; ArgentinaFil: Scala Benuzzi, María Luz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Takara, Eduardo Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Pereira, Sirley Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Regiart, Daniel Matias Gaston. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Soler Illia, Galo Juan de Avila Arturo. Universidad Nacional de San Martin. Instituto de Nanosistemas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Raba, Julio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Messina, Germán Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; Argentin

Electrochemical nanostructured biosensors for determination of ultra-trace anabolic drugs in bovine samples

Los anabólicos son drogas capaces de incrementar la retención de nitrógeno aumentando la acumulación de proteínas en los animales, son utilizados en producción agropecuaria y entrañan un serio problema para la salud pública (FAO/OMS, Roma, 1975). Entre estos compuestos se encuentran los β-agonistas, los cuales empleados en dosis bajas presentan usos terapéuticos, mientras que utilizados en altas dosis muestran su función anabolizante, generan residuos cuya acumulación representa un peligro para los consumidores. Debido al reporte de serias intoxicaciones, fue prohibida su utilización como promotores del crecimiento. El análisis de dichos residuos en muestras de origen animal requiere elevada sensibilidad y selectividad. Las metodologías usadas para su determinación son la cromatografía líquida y gaseosa con detección por espectroscopia de masas y técnicas inmunológicas como ELISA y RIA. Alternativamente, y debido a que los β-agonistas y otros anabólicos como el zeranol contienen grupos electroactivos, la detección electroquímica representa una estrategia para ser considerada. Esta detección combinada con el uso de electrodos de láminas impresas ofrece ventajas como sencillez, versatilidad, bajo precio, mínimo volumen de muestra requerido y portatibilidad del sistema, lo que permite realizar ensayos in situ. La incorporación de nanomateriales (nanopartículas metálicas, nanotubos de carbono, etc.) en la superficie de dichos electrodos posibilita mejorar la sensibilidad en comparación con los métodos tradicionales. Dichos materiales se emplean en la construcción de sensores, pues ofrecen un aumento en el área superficial, conductividad y propiedades electrocatalíticas, así como también una excelente biocompatibilidad por lo que pueden utilizarse como soportes para la inmovilización de biomoléculas en reacciones inmunológicas y/o enzimáticas.Anabolic, drugs able to increase nitrogen retention by increasing the accumulation of proteins in animals have been used in livestock production and involve a serious problem for public health (FAO/OMS, Rome 1975). Within these compounds include β-agonists, which have therapeutic uses, but to express its anabolic function require high doses, which generate waste whose accumulation represents a danger for consumers. Since the report of serious food poisoning their use as growth promoter was banned. The analysis of such residues in animal samples should be performed with high sensitivity and selectivity. The most widely used methods are techniques of liquid chromatography and gas chromatography with mass spectroscopy detection, but can also be used immunological techniques such as ELISA and RIA. Alternatively, and because the β-agonists containing electroactive groups, electrochemical detection should be considered. This detection combined with the use of screen printed carbon electrodes provides many advantages such as simplicity, versatility, low price, minimum sample volume required and portability system, which allows “in situ’’ determinations. Another strategy to improve sensitivity over traditional methods is the incorporation of nanomaterials (metal nanoparticles, carbon nanotubes, etc.). These materials represent a tool for sensors construction because they provide an increased surface area, high conductivity, electrocatalytic properties, as well as an excellent biocompatibility; therefore can be used as supports for biomolecule immobilization on immunological and/or enzymatic reactions.Fil: Regiart, Daniel Matias Gaston. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Pereira, Sirley Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Messina, Germán Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Fernández Baldo, Martín Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Spotorno, Viviana G.. Instituto Nacional de Tecnología Agropecuaria. Centro Nacional de Investigaciones Agropecuarias. Centro de Investigación de Recursos Naturales. Instituto de Recursos Biológicos; ArgentinaFil: Bertolino, Franco Adrián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; ArgentinaFil: Raba, Julio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico San Luis. Instituto de Química de San Luis; Argentin

Paper based analytical device modified with nanoporous material for the fluorescent sensing of gliadin content in different food samples

A novel fluorescent paper based immunosensor for the quantification of gliadin content in different food samples was constructed. The device consists of a paper platform modified with amino functionalized mesoporous material. The nanoporous structure and the aminofunctionality increased the anti-gliadin antibodies immobilization capacity of the sensing surface, conferring high sensitivity to the system. The detection limit reached by the described system allowed us to address the control of gluten free foods, which is extremely important to maintain the food safe consumption by patients with celiac disease, wheat allergy measured by immunoglobulin E, non-celiac gluten intolerance and Dermatitis herpetiformis or Duhring disease. The gliadin determination was performed by applying a noncompetitive immunoassay format, where gliadin present in food samples was recognized by anti-gliadin antibodies immobilized on the mesoporous material and quantified by the addition of anti-gliadin antibody labelled with peroxidase, its substrate: hydrogen peroxide and a mediator: 10-acetyl-3,7-dihydrofenoxacin. This mediator by the action of the enzyme generates resorufin, which was excited by a light emitting diode at 550 nm and emitted a signal at 580 nm. The calibration curve obtained for gliadin exhibited a linear range between 0 and 160 μg Kg−1 and a method detection limit of 0.025 mg Kg−1. The obtained values for relative recovery varied between 98.65% and 102.33% for samples enriched with gliadin. Also, the results suggested that the developed fluorescent paper based immunosensor showed good reproducibility and stability, indicating its applicability for high-sensitive gluten free food control analysis.Fil: Marin Barroso, Evelyn del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Moreira, Cristian Matias. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Messina, Germán Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Bertolino, Franco Adrián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Alderete, Mara. Universidad Nacional de San Martin. Instituto de Nanosistemas; ArgentinaFil: Soler Illia, Galo Juan de Avila Arturo. Universidad Nacional de San Martin. Instituto de Nanosistemas; ArgentinaFil: Raba, Julio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; ArgentinaFil: Pereira, Sirley Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina; Argentin

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

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