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

Anticonvulsant activity of B2, an adenosine analog, on chemical convulsant-induced seizures.

Epilepsy is a chronic neurological disorder characterized by recurrent seizures. However, approximately one-third of epilepsy patients still suffer from uncontrolled seizures. Effective treatments for epilepsy are yet to be developed. N (6)-(3-methoxyl-4-hydroxybenzyl) adenine riboside (B2) is a N(6)-substitued adenosine analog. Here we describe an investigation of the effects and mechanisms of B2 on chemical convulsant-induced seizures. Seizures were induced in mice by administration of 4-aminopyridine (4-AP), pentylenetetrazol (PTZ), picrotoxin, kainite acid (KA), or strychnine. B2 has a dose-related anticonvulsant effect in these chemical-induced seizure models. The protective effects of B2 include increased latency of seizure onset, decreased seizure occurrence, shorter seizure duration and reduced mortality rate. Radioligand binding and cAMP accumulation assays indicated that B2 might be a functional ligand for both adenosine A1 and A2A receptors. Furthermore, DPCPX, a selective A1 receptor antagonist, but not SCH58261, a selective A2A receptor antagonist, blocked the anticonvulsant effect of B2 on PTZ-induced seizure. c-Fos is a cellular marker for neuronal activity. Immunohistochemical and western blot analyses indicated that B2 significantly reversed PTZ-induced c-Fos expression in the hippocampus. Together, these results indicate that B2 has significant anticonvulsant effects. The anticonvulsant effects of B2 may be attributed to adenosine A1 receptor activation and reduced neuronal excitability in the hippocampus. These observations also support that the use of adenosine receptor agonist may be a promising approach for the treatment of epilepsy

Synthesis of Vanadium Phosphorus Oxide Catalysts Assisted by Deep-Eutectic Solvents for n-Butane Selective Oxidation

The effects of choline chloride/oxalic acid deep eutectic solvents (ChCl/OA DES) as a green and effective promoter assisting the synthesis of vanadium phosphorus oxide (VPO) catalysts for the selective oxidation of n-butane to maleic anhydride were investigated in detail. A combination of characterizations with the performance was considered to understand the essential effects of DES. DES play the role of a crystal induced agent and structural modifier, facilitating the formation of a single-crystal structure on the surface of precursor; correspondingly, topological transformation to the single-crystal active phase under the activation conditions accompany the decomposition of DES. It is suggested that ChCl/OA DES can interact with V2O5 and form a new vanadium complex, which affects the reaction between V2O5 and H3PO4. Meanwhile, the ChCl/OA DES could regulate the surface chemical state and redox characteristic, resulting in the enhancement on the catalytic performance of VPO

Anticonvulsant effects of B2 on strychnine-induced seizures in mice.

<p>(A) The latency of seizure onset was measured. Each column represents the mean ± S.E.M. (n = 7–8). ^*<i>P</i><0.05, ^**<i>P</i><0.01 and ^***<i>P</i><0.001, compared with the control group (one-way ANOVA followed by Newman Keuls post-test). (B) The mortality rate in each treatment group is shown as a percentage. ^*<i>P</i><0.05 compared with the control group (Fisher’s exact test).</p

Ionic Liquids Achieve the Exfoliation of Ultrathin Two-Dimensional VOPO4 center dot 2H(2)O Crystalline Nanosheets: Implications on Energy Storage and Catalysis

Two-dimensional (2D) nanosheets have been widely reported and applied. Among them, 2D VOPO4 center dot 2H(2)O (HVPO) is widely used in the chemical industry and energy storage field because of its polyanionic laminates. However, its layered structure is difficult to be damaged because of the strong hydrate hydrogen bonds and a small interlayer spacing. Herein, the ionic liquids (ILs) are utilized to achieve the physicochemical exfoliation of HVPO. Also, the ultrathin two-dimensional (2D) crystalline nanosheets are successfully obtained with fully exposed crystal planes and a monoatomic or few-atomic-layer structure. Further, the exfoliation mechanism of hydrogen bond destruction and recombination is proposed by combining the density functional theory (DFT) and characterization analysis. The strong hydration hydrogen bonding of an HVPO interlayer is destroyed and a system of hydrogen bonds between the cations of the ILs with a layered plate of VOPO4 and the anions of the ILs with crystal water is reformed. Besides, reassembly of the 2D nanosheets was prohibited due to the recombination of the hydrogen-bonding network. It is found that the 2D crystalline nanosheets have a quenching effect on the photoluminescence of ILs and have good electrochemical properties such as reducing the battery impedance (about 5 times less than that of the blank) and reducing the redox potential difference

Anticonvulsant activity of B2 on PTZ-induced seizure in mice.

<p>(A) The latency of seizure onset, (B) the number of seizures and (C) the seizure occurrence were measured. Each column represents the mean ± S.E.M. (n = 8–16). ^*<i>P</i><0.05, ^**<i>P</i><0.01 and ^***<i>P</i><0.001 compared with the control group (one-way ANOVA followed by Newman Keuls post-test).</p

The chemical structure of B2 (<i>N</i>⁶-(3-methoxyl-4-hydroxybenzyl) adenine riboside.

<p>The chemical structure of B2 (<i>N</i>⁶-(3-methoxyl-4-hydroxybenzyl) adenine riboside.</p