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

Microwave-Assisted Synthesis of NaCoPO₄ Red-Phase and Initial Characterization as High Voltage Cathode for Sodium-Ion Batteries

Transition metal-containing polyanion compounds are attractive for use as cathode materials in sodium-ion batteries (SIB) because they possess elevated higher intrinsic electrochemical potentials versus oxide analogs given the same M^{<i>n</i>+/(<i>n</i>+1)+} redox couple, which leads to higher energy densities. NaMPO₄ (M = transition metal) compounds have a driving force to form into the electrochemically inactive maricite phase when using conventional methods. Herein we report on the synthesis of a NaCoPO₄ (NCP) polymorph (“Red”-phase) by a microwave-assisted solvothermal process at 200 °C using tetraethylene glycol as the solvent. Ex situ XRD, XANES, and electrochemical data are used to determine the reversibility of the Co^2+/3+ redox center

Vapor-Phase Atomic-Controllable Growth of Amorphous Li₂S for High-Performance Lithium–Sulfur Batteries

Lithium–sulfur (Li–S) batteries hold great promise to meet the formidable energy storage requirements of future electrical vehicles but are prohibited from practical implementation by their severe capacity fading and the risks imposed by Li metal anodes. Nanoscale Li₂S offers the possibility to overcome these challenges, but no synthetic technique exists for fine-tailoring Li₂S at the nanoscale. Herein we report a vapor-phase atomic layer deposition (ALD) method for the atomic-scale-controllable synthesis of Li₂S. Besides a comprehensive investigation of the ALD Li₂S growth mechanism, we further describe the high performance of the resulting amorphous Li₂S nanofilms as cathodes in Li–S batteries, achieving a stable capacity of ∼800 mA·h/g, nearly 100% Coulombic efficiency, and excellent rate capability. Nanoscale Li₂S holds great potential for both bulk-type and thin-film high-energy Li–S batteries

Bulk-Sensitive Characterization of the Discharged Products in Li–O₂ Batteries by Nonresonant Inelastic X‑ray Scattering

Understanding the nature of discharged products is critical to identifying suitable electrolyte systems for Li–O₂ batteries. We have employed nonresonant inelastic X-ray scattering (NIXS), which is a hard X-ray photon-in photon-out technique to monitor low energy core–shell excitations and to obtain bulk sensitive information on the solid discharged products in Li–O₂ batteries using various electrolyte solvent/salt combinations. NIXS measurements were performed on cathodes after discharging the Li–O₂ cells using low discharge current (∼25 mA/g of carbon). NIXS results reveal that, even in cells containing current state-of-the-art electrolytes, the oxygen in the discharged products is bound predominantly to species other than a peroxide or lithia. This finding shows that electrolyte decomposition is a significant pathway during discharge of Li–O₂ batteries using ether and oligoether substituted silane based electrolytes

Enabling selective zinc-ion intercalation by a eutectic electrolyte for practical anodeless zinc batteries.

Two major challenges hinder the advance of aqueous zinc metal batteries for sustainable stationary storage: (1) achieving predominant Zn-ion (de)intercalation at the oxide cathode by suppressing adventitious proton co-intercalation and dissolution, and (2) simultaneously overcoming Zn dendrite growth at the anode that triggers parasitic electrolyte reactions. Here, we reveal the competition between Zn2+ vs proton intercalation chemistry of a typical oxide cathode using ex-situ/operando techniques, and alleviate side reactions by developing a cost-effective and non-flammable hybrid eutectic electrolyte. A fully hydrated Zn2+ solvation structure facilitates fast charge transfer at the solid/electrolyte interface, enabling dendrite-free Zn plating/stripping with a remarkably high average coulombic efficiency of 99.8% at commercially relevant areal capacities of 4 mAh cm-2 and function up to 1600 h at 8 mAh cm-2. By concurrently stabilizing Zn redox at both electrodes, we achieve a new benchmark in Zn-ion battery performance of 4 mAh cm-2 anode-free cells that retain 85% capacity over 100 cycles at 25 °C. Using this eutectic-design electrolyte, Zn | |Iodine full cells are further realized with 86% capacity retention over 2500 cycles. The approach represents a new avenue for long-duration energy storage

Structural Characterization of Aluminum (Oxy)hydroxide Films at the Muscovite (001)–Water Interface

The formation of Al (oxy)­hydroxide on the basal surface of muscovite mica was investigated to understand how the structure of the substrate controls the nucleation and growth of secondary phases. Atomic force microscopy images showed that solid phases nucleated on the surface initially as two-dimensional islands that were ≤10 Å in height and ≤200 Å in diameter after 16–50 h of reaction in a 100 μM AlCl₃ solution at pH 4.2 at room temperature. High-resolution X-ray reflectivity data indicated that these islands were gibbsite layers whose basic unit is composed of a plane of Al ions octahedrally coordinated to oxygen or hydroxyl groups. The formation of gibbsite layers is likely favored because of the structural similarity between its basal plane and the underlying mica surface. After 700–2000 h of reaction, a thicker and continuous film had formed on top of the initial gibbsite layers. X-ray diffraction data showed that this film was composed of diaspore that grew predominantly with its [040] and [140] crystallographic directions oriented along the muscovite [001] direction. These results show the structural characteristics of the muscovite (001) and Al (oxy)­hydroxide film interface where presumed epitaxy had facilitated nucleation of metastable gibbsite layers which acted as a structural anchor for the subsequent growth of thermodynamically stable diaspore grown from a mildly acidic and Al-rich solution